Healthcare Provider Details

I. General information

NPI: 1114822236
Provider Name (Legal Business Name): MICHELLE HVAM LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MORRIS AVE STE C206
UNION NJ
07083-5739
US

IV. Provider business mailing address

176 COLLEGE VIEW DR
HACKETTSTOWN NJ
07840-1025
US

V. Phone/Fax

Practice location:
  • Phone: 908-291-2727
  • Fax: 908-291-1211
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00773100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: