Healthcare Provider Details

I. General information

NPI: 1376375220
Provider Name (Legal Business Name): ALYSSA MARIE DORDONI MA, LAC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 SAINT PAUL ST STE 1C
WESTFIELD NJ
07090-2100
US

IV. Provider business mailing address

PO BOX 5
SHORT HILLS NJ
07078-0005
US

V. Phone/Fax

Practice location:
  • Phone: 908-543-9100
  • Fax:
Mailing address:
  • Phone: 732-674-8818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: