Individual provider Active NPI

Michael Nze

  • Counselor
  • Philadelphia, PA
National Provider Identifier
1962273136
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
016195 Issued in PA
Practice address
7646 Brentwood Rd
Philadelphia, PA 19151-2021
Phone
(215) 594-1527
NPI assigned
Jan 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 016195 PA Primary

Addresses

Primary practice location

7646 Brentwood Rd
Philadelphia, PA 19151-2021

Mailing address

PO Box 1394
Havertown, PA 19083-5994
Phone (215) 594-1527

Other practice location 1

7646 Brentwood Rd
Philadelphia, PA 19151-2021
Phone (215) 594-1527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240709002874 PA Practitioner - Mental Health Counselor 1052856572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016195PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Pennsylvania LLC CurrentSince Jun 15, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

2109 Red Lion Rd
Philadelphia, PA 19115
Phone (215) 213-7000

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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1962273136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1394",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835994",
            "telephone_number": "215-594-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7646 BRENTWOOD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512021",
            "telephone_number": "215-594-1527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7646 Brentwood Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191512021",
            "country_code": "US",
            "telephone_number": "215-594-1527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NZE",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "016195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.