Healthcare Provider Details

I. General information

NPI: 1023811080
Provider Name (Legal Business Name): LIFE COACHING AND CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MORRIS TPKE
RANDOLPH NJ
07869-2831
US

IV. Provider business mailing address

19 TAMARI CT
RANDOLPH NJ
07869-1828
US

V. Phone/Fax

Practice location:
  • Phone: 862-243-0512
  • Fax:
Mailing address:
  • Phone: 516-610-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ERICA CRISTINA GERACI
Title or Position: OWNER
Credential: PHD
Phone: 516-610-9999