Healthcare Provider Details

I. General information

NPI: 1114463999
Provider Name (Legal Business Name): POONAM V DOSHI LPC, NCC, CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. POONAM R NAGDA

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3607
US

IV. Provider business mailing address

610, VALLEY HEALTH PLAZA
PARAMUS NJ
07652
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-8200
  • Fax:
Mailing address:
  • Phone: 201-265-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00551400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: