JERMAINE HIBBERT LAC
NPI 1417711367
Counselor - Professional in Clifton, NJ

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since February 12, 2024PECOS EnrolledAccepts Medicare Assignment

935 ALLWOOD RD STE 300, CLIFTON, NJ 07012(862) 930-5700 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Jermaine Hibbert Lac NPPES

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

JERMAINE HIBBERT LAC (NPI 1417711367) is an individual professional provider in Clifton, New Jersey and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1417711367

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameJERMAINE HIBBERTCredential: LAC

Location Address935 ALLWOOD RD STE 300Clifton, NJ 07012-1988

Mailing Address25 Dodd StNutley, NJ 07110-1715 · (917) 244-0885

Phone(862) 930-5700

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateFebruary 12, 2024

NPPES CertifiedFebruary 12, 2024

✔ NPI 1417711367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

935 ALLWOOD RD STE 300, Clifton, NJ 07012

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Jermaine Hibbert Lac 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 ID345772851

PECOS Enrollment IDI20241022000580

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.