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General NPI Number Information
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NPI Number | 1124869797
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Entity Type | Organization
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Legal Business Name | INNER LIGHT MENTAL HEALTH AND ADDICTION SERVICES L.L.C
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1767 MORRIS AVE STE 303B
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City | UNION
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State | NJ
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Zip | 07083-3511
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Country | US
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Telephone | 973-920-7328
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Fax | 973-435-6873
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Provider Business Mailing Address
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Address Line | 1767 MORRIS AVE STE 303B
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City | UNION
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State | NJ
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Zip | 07083-3511
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Country | US
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Telephone | 862-218-2616
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MS. VANESSA DOOBAY
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Credential | NP
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Telephone | 862-218-2616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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