Healthcare Provider Details

I. General information

NPI: 1164144051
Provider Name (Legal Business Name): LILAH SOUZA LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 LINCOLN HWY STE 224
EDISON NJ
08820-3965
US

IV. Provider business mailing address

667 BROADWAY APT 3
BAYONNE NJ
07002-4762
US

V. Phone/Fax

Practice location:
  • Phone: 732-253-4354
  • Fax:
Mailing address:
  • Phone: 561-876-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01028500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012186
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: