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General NPI Number Information
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NPI Number | 1053900829
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Entity Type | Individual
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Provider Name | ALEXANDRIA LANZA
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 500 N FRANKLIN TPKE STE 302
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City | RAMSEY
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State | NJ
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Zip | 07446-1160
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Country | US
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Telephone | 201-500-9619
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N FRANKLIN TPKE STE 302
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City | RAMSEY
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State | NJ
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Zip | 07446-1160
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Country | US
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Telephone | 201-500-9619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00683100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC00683100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00272400
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 17-527
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License Number State | NJ
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