Healthcare Provider Details

I. General information

NPI: 1174436604
Provider Name (Legal Business Name): ALIYHA ELK
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 NJ-10 EAST SUITE 129
PARSIPPANY NJ
07054
US

IV. Provider business mailing address

2126 CREEK RD
HAINESPORT NJ
08036-2774
US

V. Phone/Fax

Practice location:
  • Phone: 973-829-6960
  • Fax:
Mailing address:
  • Phone: 949-616-2045
  • 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:
Title or Position:
Credential:
Phone: