Individual provider Active NPI

Jesenia Vergel

  • Professional Counselor
  • Jersey City, NJ
National Provider Identifier
1861533341
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00340800 Issued in NJ
Practice address
179 Palisade Ave
Jersey City, NJ 07306-1103
Phone
(201) 795-8375
Fax
(201) 418-7074
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00340800 NJ Primary

Addresses

Primary practice location

179 Palisade Ave
Jersey City, NJ 07306-1103

Mailing address

179 Palisade Ave
Jersey City, NJ 07306-1103
Phone (201) 795-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202002256 NJ Practitioner - Marriage and Family Therapist 2466805759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Jersey Behavioral Health PCGroup PAC ID 4284001025, 127 clinicians

Practice addresses (Care Compare)

95 N State RT
17 Suite 100
Paramus, NJ 07652-2648
Phone (732) 982-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00340800NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Behavioral Health P.C CurrentSince Jan 1, 2024 Accepting new patients
PHC of Buffalo Grove Clinical Psychology PastSince Jan 1, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

150 Morristown Rd
Ste 108
Bernardsville, NJ 07924
Phone (844) 259-2366

67 Walnut Ave
Ste 207
Clark, NJ 07066
Phone (267) 800-6027

95 N State Rt 17
Ste 100
Paramus, NJ 07652
Phone (551) 368-0304

88 Princeton Hightstown Rd
Ste 202
West Windsor, NJ 08550
Phone (609) 497-4900

Organizations & group practices 2

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861533341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061103",
            "telephone_number": "201-795-8375",
            "fax_number": "201-418-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061103",
            "telephone_number": "201-795-8375",
            "fax_number": "201-418-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGEL",
        "first_name": "JESENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00340800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.