Healthcare Provider Details

I. General information

NPI: 1730832122
Provider Name (Legal Business Name): ELIYAHU SERKEZ LPC, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 ROUTE 17 STE 33
UPPER SADDLE RIVER NJ
07458-2307
US

IV. Provider business mailing address

31 LORRAINE DR
CLIFTON NJ
07012-1243
US

V. Phone/Fax

Practice location:
  • Phone: 845-288-3139
  • Fax:
Mailing address:
  • Phone: 845-480-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014139-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01066200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: