Healthcare Provider Details

I. General information

NPI: 1174212898
Provider Name (Legal Business Name): HOPE AND HEALING COUNSELING NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/08/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E RIDGEWOOD AVE STE 415
PARAMUS NJ
07652-3915
US

IV. Provider business mailing address

600 GETTY AVE STE 101
CLIFTON NJ
07011-2161
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 201-665-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LENA CHAMBERLAIN
Title or Position: OWNER
Credential:
Phone: 757-535-4811