Douglas Edmund Rynkewicz, MA, EDS, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00440200 Issued in NJ

Practice address

795 Woodlane Rd Ste 300
Westampton, NJ 08060-3832

Phone

(609) 267-1377

NPI assigned

Nov 11, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Treatment Services IncGroup PAC ID 0042526899, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Legacy Treatment Services Inc

  • Community/Behavioral Health Agency
  • Hainesport, NJ
  • NPI 1730594656
  Medicare reassignment Care Compare group NPD
• Legacy Treatment Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pennington, NJ
  • NPI 1770362253
  NPD

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1922764273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 HARBOUR DR APT B",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190206120",
            "telephone_number": "609-658-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WOODLANE RD STE 300",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080603832",
            "telephone_number": "609-267-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYNKEWICZ",
        "first_name": "DOUGLAS",
        "middle_name": "EDMUND",
        "credential": "MA, EDS, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NJ",
            "license": "1094746",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00440200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Russo
• Dana Celeste Rutigliano
• Lynda Grace Rutter
• June A Ryan
• Horace Ryans Jr., M.S.ED.
• Nia Sabb
• John M Sacco
• George Sackie
• James L Sackie
• Mark Lawrance Sackie

• Professional Counselor in Westampton, NJ
• Providers in Westampton, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.

Verify at the official NPI Registry.