Healthcare Provider Details

I. General information

NPI: 1639751993
Provider Name (Legal Business Name): GERALD E MULLER JR. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

482 SPRINGFIELD AVE
SUMMIT NJ
07901-2601
US

IV. Provider business mailing address

57 MORRIS AVE UNIT 1
SUMMIT NJ
07901-3953
US

V. Phone/Fax

Practice location:
  • Phone: 908-273-5558
  • Fax:
Mailing address:
  • Phone: 201-355-7869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00270300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: