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NPI Code Detail

MEDICARE: IRENA SOFIA NOWOSLAWSKI LMHC, LPC

MEDICARE: IRENA SOFIA NOWOSLAWSKI LMHC, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1235787920
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENA SOFIA NOWOSLAWSKI LMHC, LPC
Provider Business Mailing Address
First Line : 111 TOWN SQUARE PL STE 1238
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07310-1810
Country : US
Telephone Number : 646-236-4982
Fax Number :
Provider Business Practice Location Address
First Line : 111 TOWN SQUARE PL STE 1238
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07310-1810
Country : US
Telephone Number : 646-236-4982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 09/25/2024

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