Healthcare Provider Details

I. General information

NPI: 1710420070
Provider Name (Legal Business Name): EMILY PARODI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BROAD ST STE 300
BLOOMFIELD NJ
07003-2547
US

IV. Provider business mailing address

2 BROAD ST STE 300
BLOOMFIELD NJ
07003-2547
US

V. Phone/Fax

Practice location:
  • Phone: 201-725-4469
  • Fax:
Mailing address:
  • Phone: 201-725-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00327100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier37PC00327100
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerLICENSED PROFESSIONAL COUNSELOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: