Organization Active NPI

Vitality Counseling LCSW PC

  • Clinical Social Worker
  • Hackensack, NJ
National Provider Identifier
1790519122
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
VITALITY COUNSELING LCSW PC
Practice address
2 University PLZ Ste 100
Hackensack, NJ 07601-6210
Phone
(631) 834-8647
NPI assigned
Aug 28, 2024
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Jessica Grace Thalhamer, LCSWNPI 1639647837
Title
Owner
Phone
(631) 834-8647

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2 University PLZ Ste 100
Hackensack, NJ 07601-6210

Mailing address

2 University PLZ Ste 100
Hackensack, NJ 07601-6210
Phone (631) 834-8647

Other practice location 1

1 Blue Hill Plz Ste 1509
Pearl River, NY 10965-3165
Phone (631) 834-8647

Other practice location 2

11 Thayer Pl
West Islip, NY 11795-4331
Phone (631) 834-8647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241016001779 NY Part B Supplier - Clinic/Group Practice 6406388347 Receives reassigned benefits from 1 practitioner
Practice locations: Pearl River, NY

National Provider Directory

National Provider Directory

Locations

2 University Plz
Ste 100
Hackensack, NJ 07601
Phone (201) 744-7749

480 Union Blvd
Unit 188
West Islip, NY 11795
Phone (631) 834-8647

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1790519122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 100",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016210",
            "telephone_number": "631-834-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 100",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016210",
            "telephone_number": "631-834-8647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Blue Hill Plz Ste 1509",
            "address_purpose": "LOCATION",
            "city": "Pearl River",
            "state": "NY",
            "postal_code": "109653165",
            "country_code": "US",
            "telephone_number": "631-834-8647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Thayer Pl",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954331",
            "country_code": "US",
            "telephone_number": "631-834-8647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITALITY COUNSELING LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "THALHAMER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-834-8647",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.