Nicole Tierney
Individual provider Active NPI Mental Health Counselor · Belford, NJ
NPI 1861101768 · NPPES record last updated Nov 18, 2022
Key facts
- NPI
- 1861101768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 37AC00562300 (NJ)
- Practice address
- 25 W Park Ave
Belford, NJ 07718-1046 - Phone
- (732) 687-9796
- NPI assigned
- Nov 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Belford, NJ 07718
Phone (732) 687-9796
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231220001967 | NJ | Practitioner - Mental Health Counselor | 0941650790 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00361200 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 37AC00562300 | NJ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CPC Integrated Health, Inc. | Single Specialty | Current | Accepting new patients |
| CPC Behavioral Healthcare, Inc | Single Specialty | Current |
Accepting new patients |
| Hope-Fullness Counseling, Prevention, and Education | Single Specialty | Current |
Accepting new patients |
Locations
10 Industrial Way E
Eatontown, NJ 07724
Phone (732) 935-2220
22 Court St
Freehold, NJ 07728
Phone (732) 780-7387
4539 US Highway 9
Howell, NJ 07731
Phone (732) 901-5553
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 37LC00361200 | NJ | |
| Mental Health Counselor | 101YM0800X | 37AC00562300 | NJ | Yes |
Addresses
Primary practice location
25 W Park Ave
Belford, NJ 07718-1046
Mailing address
25 W Park Ave
Belford, NJ 07718-1046
Phone (732) 687-9796
Other providers in Belford, NJ
- Adam Silversmith
- James W. Smith
- Marina Snead
- Jisette Soto
- Briana Stiles
- VBS RX LLC
- Gabrielle Vitaliano
- Walgreen Co
- Carol S. Walker
- Susan Wildermann
All providers in Belford, NJ · Mental Health Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.