Healthcare Provider Details

I. General information

NPI: 1780366633
Provider Name (Legal Business Name): JUSTIN GASSER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 MILLBURN AVE # 2001
SHORT HILLS NJ
07078-2508
US

IV. Provider business mailing address

514 MILLBURN AVE # 2001
SHORT HILLS NJ
07078-2508
US

V. Phone/Fax

Practice location:
  • Phone: 908-858-3874
  • Fax: 973-376-4938
Mailing address:
  • Phone: 908-858-3874
  • Fax: 973-376-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01206600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37PC01206600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01206600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: