Active NPI
Mary Helen Kellam
- Professional Counselor
- Sparta, NJ
National Provider Identifier
1891189825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00514800
- Practice address
- 17 Woodport Rd
Suite 2D
Sparta, NJ 07871-2412 - Phone
- (201) 317-4539
- NPI assigned
- Mar 27, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 37PC00514800 | NJ | Primary |
Addresses
Primary practice location
17 Woodport Rd
Suite 2D
Sparta, NJ 07871-2412
Mailing address
17 Woodport Rd
Suite 2D
Sparta, NJ 07871-2412
Phone (201) 317-4539
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 9, 2025 through Mar 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00514800 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1891189825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 WOODPORT RD",
"address_2": "SUITE 2D",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078712412",
"telephone_number": "201-317-4539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WOODPORT RD",
"address_2": "SUITE 2D",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078712412",
"telephone_number": "201-317-4539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLAM",
"first_name": "MARY HELEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-27",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00514800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.