Healthcare Provider Details

I. General information

NPI: 1124508320
Provider Name (Legal Business Name): CORRIANNE CONTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 NORTH AVE E STE 1A
CRANFORD NJ
07016-2461
US

IV. Provider business mailing address

340 NORTH AVE E STE 1A
CRANFORD NJ
07016-2461
US

V. Phone/Fax

Practice location:
  • Phone: 908-913-7704
  • Fax:
Mailing address:
  • Phone: 908-913-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01295000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: