Healthcare Provider Details

I. General information

NPI: 1821955238
Provider Name (Legal Business Name): SALT AND LIGHT COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 KNOLL CREST AVE
BRICK NJ
08723-7517
US

IV. Provider business mailing address

171 KNOLL CREST AVE
BRICK NJ
08723-7517
US

V. Phone/Fax

Practice location:
  • Phone: 848-448-6422
  • Fax: 848-448-6422
Mailing address:
  • Phone: 848-448-6422
  • Fax: 848-448-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CINDY DORNACKER
Title or Position: OWNER
Credential: LCSW
Phone: 848-448-6422