Anxiety Leader LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ANXIETY LEADER LLC

Practice address

619 Bernita Dr
River Vale, NJ 07675-5905

Phone

(732) 689-0171

NPI assigned

Apr 11, 2024

Last updated

Apr 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary J Jose, LPCNPI 1619625563

Title

Owner

Phone

(732) 689-0171

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Jean Jose, LAC

  • Mental Health Counselor
  • River Vale, NJ
  • NPI 1619625563
  NPD Authorized official

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1952154577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 BERNITA DR",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076755905",
            "telephone_number": "732-689-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 BERNITA DR",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076755905",
            "telephone_number": "732-689-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY LEADER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-689-0171",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in River Vale, NJ
• Providers in River Vale, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.