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General NPI Number Information
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NPI Number | 1417567876
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Entity Type | Individual
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Provider Name | YUSUF NATHANIEL SHAHEED LCADC
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Gender | Male
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 2130 MILLBURN AVE STE D1
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3749
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Country | US
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Telephone | 973-763-8123
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Fax |
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Provider Business Mailing Address
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Address Line | 61 HOBSON ST FL 2
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City | NEWARK
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State | NJ
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Zip | 07112-1308
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Country | US
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Telephone | 973-763-8123
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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