Rose Fedechko, LPC/COTA
Counselor, Professional in Mantua, New Jersey
1104600758- Practice location
- 550 Bridgeton Pike Ste 2, Mantua, NJ 08051-1318
- Phone
- 856-746-4244
- Fax
- —
- Last updated
- April 9, 2026
Rose Fedechko is a Counselor, Professional based in Mantua, NJ. Rose Fedechko practices in Mantua, NJ and has the professional credentials of LPC/COTA. The NPI Number for Rose Fedechko is 1104600758 and holds a License No. 46TA09094500 (NJ). The current practice location address for Rose Fedechko is 550 Bridgeton Pike Ste 2, Mantua, NJ 08051-1318 and can be reached out via phone at 856-746-4244.
Provider Profile Details
- NPI Number
- 1104600758
- Provider Name
- Rose Fedechko
- Credential
- LPC/COTA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 550 Bridgeton Pike Ste 2, Mantua, NJ 08051-1318
- Phone Number
- 856-746-4244
- Primary Taxonomy
- Counselor, Professional · 101YP2500X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- August 23, 2023
- Last Update Date
- April 9, 2026
- Certification Date
- April 9, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 550 Bridgeton Pike Ste 2
Mantua, NJ 08051-1318 - City
- Mantua
- State
- New Jersey
- Zip
- 08051-1318
- Phone Number
- 856-746-4244
Provider Business Mailing Address Details
- Address
- Po Box 366
Mount Royal, NJ 08061-0366 - City
- Mount Royal
- State
- NJ
- Zip
- 08061-0366
- Phone Number
- 856-746-4244
License Information
- License Number (1)
- 46TA09094500
- License State (1)
- NJ
- Taxonomy (1)
- Occupational Therapy Assistant · 224Z00000X
- License Number (2)
- 37PC01223700
- License State (2)
- NJ
- Taxonomy (2)
- Counselor, Professional · 101YP2500X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Rose Fedechko, LPC/COTA?
The NPI number of Rose Fedechko, LPC/COTA is 1104600758. It was assigned on August 23, 2023 and is currently active in the NPPES registry.
What is the specialty of Rose Fedechko, LPC/COTA?
Rose Fedechko, LPC/COTA is registered under the primary taxonomy Counselor, Professional (code 101YP2500X), licensed in NJ under license number 46TA09094500.
Where does Rose Fedechko, LPC/COTA practice?
The practice location is 550 Bridgeton Pike Ste 2, Mantua, NJ 08051-1318. The office can be reached at 856-746-4244 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104600758 directly on the NPPES registry website.