Individual provider Active NPI

Theresa Soda, LPC

  • Professional Counselor
  • Laurel Springs, NJ
National Provider Identifier
1871285916
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00288800 Issued in NJ
Practice address
1387 Chews Landing Rd
Laurel Springs, NJ 08021-2760
Phone
(856) 454-3104
NPI assigned
May 25, 2023
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 37PC00288800 NJ Primary

Addresses

Primary practice location

1387 Chews Landing Rd
Laurel Springs, NJ 08021-2760

Mailing address

1387 Chews Landing Rd
Laurel Springs, NJ 08021-2760

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
I20241121000078 NJ Practitioner - Mental Health Counselor 0143755660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00288800NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Bay Wellness, LLC CurrentSince May 28, 2023 Accepting new patients
Hunterdon Medical Center CurrentSince Aug 22, 2024 Accepting new patients
Hunterdon Medical Center CurrentSince Aug 22, 2024 Accepting new patients

Locations

2100 Wescott Dr
Flemington, NJ 08822
Phone (908) 237-5420

1387 Chews Landing Rd
Laurel Springs, NJ 08021
Phone (855) 760-2933

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1871285916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 CHEWS LANDING RD",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "080212760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 CHEWS LANDING RD",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "080212760",
            "telephone_number": "856-454-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODA",
        "first_name": "THERESA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00288800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel Springs, NJ

Sources for this page

Verify at the official NPI Registry.