Active NPI
Alexandra Fetzer, PHD
- Counselor
- Millburn, NJ
National Provider Identifier
1881046506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 001995
- Practice address
- 90 Millburn Ave
Millburn, NJ 07041-1945 - Phone
- (973) 378-5525
- NPI assigned
- Jul 6, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 001995 | NY | Primary |
Addresses
Primary practice location
90 Millburn Ave
Millburn, NJ 07041-1945
Mailing address
20 Highland Ave
Madison, NJ 07940-2109
Phone (862) 812-5859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001995 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1881046506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 HIGHLAND AVE",
"city": "MADISON",
"state": "NJ",
"postal_code": "079402109",
"telephone_number": "862-812-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 MILLBURN AVE",
"city": "MILLBURN",
"state": "NJ",
"postal_code": "070411945",
"telephone_number": "973-378-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETZER",
"first_name": "ALEXANDRA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-06",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": "001995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millburn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.