Healthcare Provider Details

I. General information

NPI: 1417013962
Provider Name (Legal Business Name): JOYCE MIERZEJWSKI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 POMPTON AVE SUITE 202
VERONA NJ
07044-2942
US

IV. Provider business mailing address

826 MAIN ST APT. C
BELLEVILLE NJ
07109-3420
US

V. Phone/Fax

Practice location:
  • Phone: 973-857-5333
  • Fax: 973-857-5338
Mailing address:
  • Phone: 973-751-4207
  • Fax: 973-857-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC0515
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: