=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093307365
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIMITLESS WELLNESS COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2021
-----------------------------------------------------
Last Update Date | 04/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 116 BARNERT AVE
-----------------------------------------------------
City | TOTOWA
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07512-1640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-652-4753
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 576 VALLEY RD # 263
-----------------------------------------------------
City | WAYNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07470-3526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-652-4753
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LPC
-----------------------------------------------------
Name | NADIA HASSAN
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 973-692-6293
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------