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General NPI Number Information
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NPI Number | 1194675868
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Entity Type | Organization
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Legal Business Name | VERSATILE THERAPEUTICS, LLC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 72 WALNUT ST APT 1
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City | NEWARK
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State | NJ
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Zip | 07102-4754
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Country | US
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Telephone | 973-207-5938
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Fax |
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Provider Business Mailing Address
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Address Line | 72 WALNUT ST APT 1
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City | NEWARK
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State | NJ
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Zip | 07102-4754
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Country | US
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Telephone | 973-207-5938
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JOYA A THOMPSON
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Credential | MA, LPC, ACS
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Telephone | 973-207-5938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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