Individual provider Active NPI

Nicole F Raimondi, LPC

  • Counselor
  • Clementon, NJ
National Provider Identifier
1932715422
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
37PC00897800 Issued in NJ
Practice address
1387 Chews Landing Rd
Clementon, NJ 08021-2760
Phone
(855) 765-6399
NPI assigned
Sep 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 37AC00353600 NJ
Counselor 101Y00000X 37PC00897800 NJ Primary

Addresses

Primary practice location

1387 Chews Landing Rd
Clementon, NJ 08021-2760

Mailing address

500 Park Ave
Manalapan, NJ 07726-8375

Other practice location 1

500 Park Ave
Manalapan, NJ 07726-8375
Phone (732) 679-4500

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

State licenses

LicenseStateTypeSpecialty
37AC00353600NJMDCounselor
37PC00897800NJMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Counseling and Behavioral Health, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1932715422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077268375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 CHEWS LANDING RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080212760",
            "telephone_number": "855-765-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Manalapan",
            "state": "NJ",
            "postal_code": "077268375",
            "country_code": "US",
            "telephone_number": "732-679-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAIMONDI",
        "first_name": "NICOLE",
        "middle_name": "F",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-20",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00353600",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00897800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clementon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.