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KATHLEEN VANDER VALK
NPI 1174457451
Counselor - Professional in Mountainside, NJ

Active since June 11, 2026PECOS Enrolled
200 SHEFFIELD ST STE 214, MOUNTAINSIDE, NJ 07092(862) 777-7558 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kathleen Vander Valk NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN VANDER VALK (NPI 1174457451) is an individual professional provider in Mountainside, New Jersey, licensed in New Jersey (37PC01257100) and active in the NPI registry since June 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1174457451
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKATHLEEN VANDER VALK
Location Address200 SHEFFIELD ST STE 214Mountainside, NJ 07092-2315
Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630
Phone(862) 777-7558
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 11, 2026
Last NPPES UpdateJuly 8, 2026
NPPES CertifiedJuly 8, 2026
✔ NPI 1174457451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in NJ · 37PC01257100
200 SHEFFIELD ST STE 214, Mountainside, NJ 07092
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen Vander Valk is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820557606
PECOS Enrollment IDI20260824001255
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kathleen Vander Valk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New Jersey Behavioral Health P.C
31 mi
Psychologist
231 CLARKSVILLE RD STE 4A
Princeton Junction, NJ 08550
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: New Jersey Behavioral Health PC
  • 167 clinicians in this Medicare group
NPI 1538744297 (732) 982-2888

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOLE JOIE ALVAREZ LCSW
Social Worker (Clinical)
200 SHEFFIELD ST STE 214
MOUNTAINSIDE, NJ 07092
Union County (732) 982-2888
DR. GABRIELA ALVIM DE PAULA MD
Psychiatry & Neurology (Psychiatry)
200 SHEFFIELD ST STE 214
MOUNTAINSIDE, NJ 07092
Union County (732) 982-2888
DOUGLAS A MORRISON LAC
Counselor (Professional)
200 SHEFFIELD ST STE 214
MOUNTAINSIDE, NJ 07092
Union County (732) 982-2888
DEVONNA I. GONSALVES LCSW
Social Worker (Clinical)
200 SHEFFIELD ST STE 214
MOUNTAINSIDE, NJ 07092
Union County (201) 927-3891
CINTYA GONZALEZ LAC
Counselor (Professional)
200 SHEFFIELD ST STE 214
MOUNTAINSIDE, NJ 07092
Union County (732) 982-2888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Vander Valk's NPI number?

The NPI number for Kathleen Vander Valk is 1174457451. It was assigned to this individual provider in the NPPES registry on June 11, 2026.

Where is Kathleen Vander Valk located?

Kathleen Vander Valk practices at 200 Sheffield St Ste 214, Mountainside, NJ 07092. The listed phone number is (862) 777-7558.

What is Kathleen Vander Valk's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kathleen Vander Valk enrolled in Medicare?

Yes. Kathleen Vander Valk is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathleen Vander Valk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Vander Valk reassigns Medicare benefits to New Jersey Behavioral Health P.C (Princeton Junction, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Vander Valk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathleen Vander Valk was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.