Healthcare Provider Details

I. General information

NPI: 1912852005
Provider Name (Legal Business Name): CHALIA JOYCE PERRY CPRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1230 PARKWAY AVE STE 105
EWING NJ
08628-3018
US

IV. Provider business mailing address

1230 PARKWAY AVE STE 105
EWING NJ
08628-3018
US

V. Phone/Fax

Practice location:
  • Phone: 609-393-1219
  • Fax:
Mailing address:
  • Phone: 609-393-1219
  • Fax: 609-393-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2024-000197
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPRS-50381
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: