Healthcare Provider Details

I. General information

NPI: 1881517167
Provider Name (Legal Business Name): ELEASE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 ENGLE ST APT 2D
ENGLEWOOD NJ
07631-2421
US

IV. Provider business mailing address

260 ENGLE ST APT 2D
ENGLEWOOD NJ
07631-2421
US

V. Phone/Fax

Practice location:
  • Phone: 424-325-8382
  • Fax:
Mailing address:
  • Phone: 424-325-8382
  • 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: MS. ELEASE ALCEIA WIGGINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 424-325-8382