Jaclyn Fabrizio, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00604500 Issued in NJ

Practice address

2 Paragon Way Ste 800
Freehold, NJ 07728-9573

Phone

(732) 393-8391

Fax

(731) 561-1721

NPI assigned

Jun 12, 2024

Sex

Female

Sole proprietor

No

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

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.

• Tree of Life Counseling Center, LLC

  • Mental Health Counselor
  • Freehold, NJ
  • NPI 1841711306
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1982446647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON WAY STE 800",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289573",
            "telephone_number": "732-393-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARAGON WAY STE 800",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289573",
            "telephone_number": "732-393-8391",
            "fax_number": "731-561-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIO",
        "first_name": "JACLYN",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00604500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excellent Way Counseling Services LLC
• Exspec Limited Liability Company
• Extensive Psychological Services,Inc
• Caitlin Mary Fabian, PA-C
• Lisa Fabio Ligammari, LCSW
• Nader Fahmy, M.D.
• Michael James Failla, D.C.
• Kimberly Fake
• Mitesh Girish Faldu, D.M.D
• Anthony Fam, MD

• Mental Health Counselor in Freehold, NJ
• Providers in Freehold, 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 Jun 12, 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.