Individual provider Active NPI

Richard Mohammed, LPC

  • Mental Health Counselor
  • West Orange, NJ
National Provider Identifier
1790309532
Registry record updated Jun 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00720800 Issued in NJ
Practice address
145 Marion Dr
West Orange, NJ 07052-3301
Phone
(973) 486-4559
NPI assigned
Jun 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37PC00720800 NJ Primary

Addresses

Primary practice location

145 Marion Dr
West Orange, NJ 07052-3301

Mailing address

634 Eagle Rock Ave Unit 202
West Orange, NJ 07052-6801
Phone (973) 486-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37PC00720800NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Skyheart Counseling LLC Mental Health CurrentSince Jun 28, 2020 Accepting new patients

Locations

634 Eagle Rock Ave
Unit 202
West Orange, NJ 07052

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22878/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1790309532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 EAGLE ROCK AVE UNIT 202",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070526801",
            "telephone_number": "973-486-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MARION DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523301",
            "telephone_number": "973-486-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "RICHARD",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00720800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.