Healthcare Provider Details

I. General information

NPI: 1083283980
Provider Name (Legal Business Name): PRISCILLA D ADU-ANTOH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 STUYVESANT AVE APT A
IRVINGTON NJ
07111-5112
US

IV. Provider business mailing address

1108 STUYVESANT AVE APT A APT A
IRVINGTON NJ
07111-5112
US

V. Phone/Fax

Practice location:
  • Phone: 214-267-9571
  • Fax:
Mailing address:
  • Phone: 929-333-6531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00780500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: