Kelly Ann Passanisi, LPC, LCADC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

37PC00599400 Issued in NJ

Practice address

1 Bethany Rd Ste 69
Hazlet, NJ 07730-1668

Phone

(732) 600-0342

NPI assigned

Dec 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Gaffney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Soul Work LLC

  dba Soul Work Counseling Services

  • Professional Counselor
  • Hazlet, NJ
  • NPI 1851907414

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1861907982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BROOK ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015802",
            "telephone_number": "732-600-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD STE 69",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301668",
            "telephone_number": "732-600-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Phillipsburg",
            "state": "NJ",
            "postal_code": "088651806",
            "country_code": "US",
            "telephone_number": "908-329-2144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Jack Martin Blvd",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087247772",
            "country_code": "US",
            "telephone_number": "732-920-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASSANISI",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC, LCADC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00272900",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00599400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GAFFNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counselor in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.