Healthcare Provider Details

I. General information

NPI: 1457979338
Provider Name (Legal Business Name): NKEMDILIM S OKAKPU PHD, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 VALLEY RD # 1057
CLIFTON NJ
07013-1319
US

IV. Provider business mailing address

377 VALLEY RD # 1057
CLIFTON NJ
07013-1319
US

V. Phone/Fax

Practice location:
  • Phone: 907-477-9288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: