GUSTAVO BERNARDO MEJIA (NPI# 1639295801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639295801 |
| Entity Type | Individual |
| Full Name | GUSTAVO BERNARDO MEJIA |
| Credential | MA, LPC, LCADC |
| Practice Address |
61 Grand Ave 3rd Floor Englewood NJ 07631-3572 |
| Mailing Address |
150 Tryon Ave Apt E1 Englewood NJ 07631-1670 |
| Practice Telephone | 2012451159 |
| Practice Fax Number | 2015418100 |
| Mailing Telephone | 2012451159 |
| Mailing Fax Number | 2015418100 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2011-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
37LC00170800 | NJ | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
37PC00396500 | NJ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 12063531 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821289927 | Gustavo Mejia | Chiropractor | 8 Maple Ave, Bay Shore, NY 11706-8722 | 2007-08-05 |
| Street Address |
61 GRAND AVE 3RD FLOOR |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-3572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639698004 | In Young Sohn | Social Worker | 61 Grand Ave, Englewood, NJ 07631 | 2017-09-16 |
| 1881958817 | Buddies of New Jersey, Inc. | Community/Behavioral Health | 61 Grand Ave, 3rd Floor, Englewood, NJ 07631-3572 | 2012-06-25 |
| 1164790796 | A Joseph & Associates LLC | Social Worker | 61 Grand Ave, Englewood, NJ 07631-3572 | 2011-12-10 |
| 1831470723 | Mario H Irigoyen Lcsw - LLC | Community/Behavioral Health | 61 Grand Ave, Englewood, NJ 07631-3572 | 2011-09-06 |
| 1952607608 | Mario Hipolito Irigoyen | Social Worker | 61 Grand Ave, Englewood, NJ 07631-3572 | 2011-01-27 |
| 1821392473 | Hudson River Care and Counseling, LLC | Social Worker | 61 Grand Ave, Third Floor, Englewood, NJ 07631-3572 | 2010-12-22 |
| 1013249770 | Holistic Manual Physical Therapy, Pa | Clinic/Center | 61 Grand Ave, Englewood, NJ 07631-3572 | 2010-02-05 |
| 1891020517 | Lisa Stacey | Social Worker | 61 Grand Ave, Englewood, NJ 07631-3572 | 2009-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487288320 | Karis Lambert | Counselor | 9800 Mt Pyramid Ct Ste 400, Englewood, CO 80112-2669 | 2020-03-01 |
| 1881256899 | Tani M Foger | Counselor | 64 Hillside Ave, Englewood, NJ 07631-3002 | 2019-07-01 |
| 1770042871 | Danielle Leoncini | Counselor | 35 W Hudson Ave, Englewood, NJ 07631-1718 | 2019-03-18 |
| 1700355484 | Alizah Scherr | Counselor | 20 W Palisade Ave Apt 4101, Englewood, NJ 07631-2724 | 2018-11-25 |
| 1558852285 | Christine Marissa Mathias | Counselor | 7791 S Kalispell Ct, Englewood, CO 80112-4648 | 2018-05-29 |
| 1609373471 | Tammy A Usher | Counselor | 7069 Peacock Ln, Englewood, FL 34224 | 2018-04-09 |
| 1245772243 | Darrelle Leraan Fricke | Counselor | 4191 S Eliot St, Englewood, CO 80110-4314 | 2016-11-08 |
| 1598218919 | Hudson River Care and Counseling | Counselor | 61 Grand Avenue, 3rd Floor, Englewood, NJ 07631-0000 | 2016-08-02 |
| 1336590686 | Hilary Maxwell | Counselor | 3531 S Logan St # D-160, Englewood, CO 80113-3700 | 2016-06-28 |
| 1518291012 | Ruth Vivien Darling-goldberg | Counselor | 10 Inverness Dr E, Suite 225, Englewood, CO 80112-5610 | 2009-09-30 |
| Find all providers in ENGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.