Healthcare Provider Details

I. General information

NPI: 1871423988
Provider Name (Legal Business Name): DR. SALENA JUSTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S BROAD ST STE B
BREVARD NC
28712-3768
US

IV. Provider business mailing address

212 S BROAD ST STE B
BREVARD NC
28712-3768
US

V. Phone/Fax

Practice location:
  • Phone: 201-687-9113
  • Fax:
Mailing address:
  • Phone: 201-687-9113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SALENA JUSTICE
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 407-310-0908