Healthcare Provider Details

I. General information

NPI: 1710570866
Provider Name (Legal Business Name): MR. DARREN SINATRA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BROADVIEW AVE
BERLIN NJ
08009-1617
US

IV. Provider business mailing address

7 BROADVIEW AVE
BERLIN NJ
08009-1617
US

V. Phone/Fax

Practice location:
  • Phone: 856-419-7405
  • Fax:
Mailing address:
  • Phone: 856-419-7405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00157900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC00456500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: