JENNIFER D DERISSE LCADC
NPI 1336784826
Counselor - Addiction (Substance Use Disorder) in Kearny, NJ

Active since November 08, 2019PECOS EnrolledAccepts Medicare Assignment
206 BERGEN AVE, KEARNY, NJ 07032(732) 210-0509 Get Directions Write a Review

NPPES record last updated: November 8, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jennifer D Derisse Lcadc NPPES

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

JENNIFER D DERISSE LCADC (NPI 1336784826) is an individual addiction (substance use disorder) provider in Kearny, New Jersey, licensed in (37LC00296100) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1336784826
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJENNIFER D DERISSECredential: LCADC
Location Address206 BERGEN AVEKearny, NJ 07032-3384
Mailing Address206 Bergen AveKearny, NJ 07032-3384 · (732) 210-0509
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateNovember 8, 2019
NPI 1336784826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed · 37LC00296100
206 BERGEN AVE, Kearny, NJ 07032

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jennifer D Derisse Lcadc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113452251
PECOS Enrollment IDI20241126001056
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.

Other Providers at the Same Location NPPES 18

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

Emergency Medicine
206 BERGEN AVE
KEARNY, NJ 07032
Community/Behavioral Health
206 BERGEN AVE
KEARNY, NJ 07032
Clinic/Center (Rehabilitation, Substance Use Disorder)
206 BERGEN AVE
KEARNY, NJ 07032
Substance Abuse Rehabilitation Facility
206 BERGEN AVE
KEARNY, NJ 07032
Anesthesiology
206 BERGEN AVE
KEARNY, NJ 07032
Clinic/Center (Rehabilitation, Substance Use Disorder)
206 BERGEN AVE
KEARNY, NJ 07032
Physical Therapist
206 BERGEN AVE
KEARNY, NJ 07032
Allergy & Immunology (Allergy)
206 BERGEN AVE, SUITE 202
KEARNY, NJ 07032

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 Jennifer Derisse's NPI number?

The NPI number for Jennifer Derisse is 1336784826. It was assigned to this individual provider in the NPPES registry on November 8, 2019.

Where is Jennifer Derisse located?

Jennifer Derisse practices at 206 Bergen Ave, Kearny, NJ 07032. The listed phone number is (732) 210-0509.

What is Jennifer Derisse's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Jennifer Derisse enrolled in Medicare?

Yes. Jennifer Derisse is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jennifer Derisse accept?

Health plans from Providence Health Plan list Jennifer Derisse as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Derisse was last updated on November 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.