Healthcare Provider Details

I. General information

NPI: 1508198326
Provider Name (Legal Business Name): LEIGH KOLODNY-KRAFT LPC, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 COLUMBIA TPKE STE 201A
FLORHAM PARK NJ
07932-2192
US

IV. Provider business mailing address

123 COLUMBIA TPKE STE 201A
FLORHAM PARK NJ
07932-2192
US

V. Phone/Fax

Practice location:
  • Phone: 862-485-0328
  • Fax: 973-520-8540
Mailing address:
  • Phone: 862-485-0328
  • Fax: 973-520-8540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00716900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00716900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00142600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: