Individual provider Active NPI

Lisamarie Slattery, LPC

  • Professional Counselor
  • New Providence, NJ
National Provider Identifier
1922555283
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00112000 Issued in NJ
Practice address
890 Mountain Ave
New Providence, NJ 07974-1218
Phone
(908) 277-8900
Fax
(908) 508-8919
NPI assigned
Sep 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 37PC00112000 NJ
Professional Counselor 101YP2500X 37PC00112000 NJ Primary

Addresses

Primary practice location

890 Mountain Ave
New Providence, NJ 07974-1218

Mailing address

16 Woodlawn Dr
Chatham, NJ 07928-1163
Phone (973) 886-9171

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
I20240624001619 NJ Practitioner - Mental Health Counselor 3476096009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00112000NJMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Mar 18, 2024 Accepting new patients
Summit Medical Group PA CurrentSince Mar 18, 2024 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

890 Mountain Ave
New Providence, NJ 07974
Phone (908) 277-8799

Interoperability endpoints

  • Direct secure messaging: lisamarie.slattery.1@2983.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1922555283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WOODLAWN DR",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281163",
            "telephone_number": "973-886-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 MOUNTAIN AVE",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741218",
            "telephone_number": "908-277-8900",
            "fax_number": "908-508-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "LISAMARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-04",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00112000",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00112000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Providence, NJ

Sources for this page

Verify at the official NPI Registry.