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General NPI Number Information
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NPI Number | 1427794015
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Entity Type | Organization
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Legal Business Name | AMBROSIUS COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 05/07/2022
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Last Update Date | 05/07/2022
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Provider Practice Location Address
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Address Line | 85 PARK ST STE 1A
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3465
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Country | US
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Telephone | 332-334-9982
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Fax |
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Provider Business Mailing Address
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Address Line | 85 PARK ST STE 1A
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3465
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Country | US
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Telephone | 332-334-9982
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | DR. MICHAELA AMBROSIUS
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Credential | LPC, LMHC
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Telephone | 212-464-8809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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