Healthcare Provider Details

I. General information

NPI: 1447965520
Provider Name (Legal Business Name): PAULINE DAVID LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 PARK AVE STE 101
SOUTH PLAINFIELD NJ
07080-5565
US

IV. Provider business mailing address

37 NEW LOTS AVE APT C1
BROOKLYN NY
11212-6923
US

V. Phone/Fax

Practice location:
  • Phone: 908-279-6705
  • Fax:
Mailing address:
  • Phone: 134-781-5586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00938800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: