Active NPI
Walter E Nolan, M.A.,LAC
- Professional Counselor
- Englewood, NJ
National Provider Identifier
1871926329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37AC00067100
- Practice address
- 93 W Palisade Ave
Englewood, NJ 07631-2611 - Phone
- (201) 567-0500
- NPI assigned
- Aug 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37AC00067100 | NJ | Primary |
Addresses
Primary practice location
93 W Palisade Ave
Englewood, NJ 07631-2611
Mailing address
93 W Palisade Ave
Englewood, NJ 07631-2611
Phone (201) 567-0500
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15 -01 Broadway
Suite 6
Fair Lawn, NJ 07410-6006
Phone (201) 342-4004
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00067100 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairlawn Behavioral Associates LLC | Current | Accepting new patients |
Locations
15-01 Broadway
Ste 6
Fair Lawn, NJ 07410
Phone (201) 342-4004
Organizations & group practices 1
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.
-
- Prescribing (Medical) Psychologist
- Fair Lawn, NJ
- NPI 1861876419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1871926329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 W PALISADE AVE",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076312611",
"telephone_number": "201-567-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 W PALISADE AVE",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076312611",
"telephone_number": "201-567-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "WALTER",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "M.A.,LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-19",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37AC00067100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.