Healthcare Provider Details

I. General information

NPI: 1487561502
Provider Name (Legal Business Name): ELENA PARIS MELT MA, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 HIGH ST APT D23
FAIR LAWN NJ
07410-3598
US

IV. Provider business mailing address

302 HIGH ST APT D23
FAIR LAWN NJ
07410-3598
US

V. Phone/Fax

Practice location:
  • Phone: 973-388-4849
  • Fax:
Mailing address:
  • Phone: 973-388-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00994500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: