Christine Bae, LAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

37AC00395500 Issued in NJ

Practice address

180 Old Tappan
Building #3, 2ND Floor
Old Tappan, NJ 07675-1204

Phone

(845) 535-1456

NPI assigned

Jun 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1942869359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 OLD TAPPAN",
            "address_2": "BUILDING #3, 2ND FLOOR",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076751204",
            "telephone_number": "845-535-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 OLD TAPPAN",
            "address_2": "BUILDING #3, 2ND FLOOR",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076751204",
            "telephone_number": "845-535-1456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Island Rd Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Ramsey",
            "state": "NJ",
            "postal_code": "074462822",
            "country_code": "US",
            "telephone_number": "201-995-1128 x6",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAE",
        "first_name": "CHRISTINE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00395500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.