Healthcare Provider Details

I. General information

NPI: 1134500366
Provider Name (Legal Business Name): KADIAN P. PEYNADO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 7TH ST STE 215
PLAINFIELD NJ
07060-1629
US

IV. Provider business mailing address

120 W 7TH ST STE 215
PLAINFIELD NJ
07060-1629
US

V. Phone/Fax

Practice location:
  • Phone: 908-531-6905
  • Fax:
Mailing address:
  • Phone: 908-531-6905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00440300
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: