Healthcare Provider Details

I. General information

NPI: 1154247369
Provider Name (Legal Business Name): TIMA THERAPIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SUMMIT AVENUE SUITE 1 PMB 1042
JERSEY CITY NJ
07304
US

IV. Provider business mailing address

217 SUMMIT AVENUE SUITE 1 PMB 1042
JERSEY CITY NJ
07304
US

V. Phone/Fax

Practice location:
  • Phone: 929-345-0263
  • Fax:
Mailing address:
  • Phone: 929-345-0263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: FATIMA LUNDY
Title or Position: PSYCHOTHERAPIST/FOUNDER
Credential:
Phone: 929-345-0263