Healthcare Provider Details

I. General information

NPI: 1912865643
Provider Name (Legal Business Name): MARGIT MALACRIDA MA, LAC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KALISA WAY STE 211
PARAMUS NJ
07652-3538
US

IV. Provider business mailing address

1 KALISA WAY STE 211
PARAMUS NJ
07652-3538
US

V. Phone/Fax

Practice location:
  • Phone: 201-652-5114
  • Fax: 201-652-6253
Mailing address:
  • Phone: 201-652-5114
  • Fax: 201-652-6253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00821900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: