Theracorp, LLC
NPI 1063947828ActiveOrganization· Social Worker, Clinical· Jamesburg, NJ
Social Worker, Clinical in Jamesburg, New Jersey, registered in NPPES in April 2017. The authorized official on file is Alla Krutyansky, MSW, LCSW, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063947828 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 28, 2017 |
| Last updated in NPPES | Nov 11, 2021 |
| Certified by provider | Nov 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 1041X0700X | NJ |
| Counselor | 101Y00000X | 101Y00000X | NJ |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 101YA0400X | NJ |
| Counselor, Mental Health | 101YM0800X | 104200000X | NJ |
| Counselor, Mental Health | 101YM0800X | 101YM0800X | NJ |
| Psychologist | 103T00000X | 103T00000X | NJ |
| Psychologist, Prescribing (Medical) | 103TP0016X | 103TP0016X | NJ |
| Psychologist, Group Psychotherapy | 103TP2701X | — | NJ |
| Marriage & Family Therapist | 106H00000X | 106H00000X | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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