Healthcare Provider Details

I. General information

NPI: 1649092172
Provider Name (Legal Business Name): ANGELINE GUZMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOREST AVE
PARAMUS NJ
07652-5429
US

IV. Provider business mailing address

10 RIVER RD APT B
NUTLEY NJ
07110-3459
US

V. Phone/Fax

Practice location:
  • Phone: 201-490-5158
  • Fax:
Mailing address:
  • Phone: 201-956-8993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC06407700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06407700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: