Healthcare Provider Details

I. General information

NPI: 1508723362
Provider Name (Legal Business Name): DENYS HENRIQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SUMMIT AVE
HACKENSACK NJ
07601-1429
US

IV. Provider business mailing address

166 PRESCOTT AVE
PROSPECT PARK NJ
07508-2248
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-0408
  • Fax:
Mailing address:
  • Phone: 201-927-1917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SL0364200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: