Facts
- Status
- A
- Credential
- PhD, LPC
- Type
- Individual
- Enumeration date
- 2019-08-08
- Last updated
- 2026-09-16
Specialties
Licenses
- License NJ
- 37PC00783300
Location
- Practice location
- 1012 BROAD ST
- City
- BLOOMFIELD NJ
- Postal code
- 070032807
- Phone
- 201-803-7968
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.