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General NPI Number Information
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NPI Number | 1457074262
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Entity Type | Organization
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Legal Business Name | EQUANIMITY COUNSELING LLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 900 ROUTE 168 # E1-E2
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City | BLACKWOOD
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State | NJ
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Zip | 08012-3233
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Country | US
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Telephone | 856-271-4490
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Fax |
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Provider Business Mailing Address
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Address Line | 455 PENN BLVD
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City | WOODBURY
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State | NJ
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Zip | 08096-2821
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Country | US
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Telephone | 856-739-0402
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Fax |
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Authorized Official
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Title or Position | OWNER / OUTPATIENT THERAPIST
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Name | MS. NAHI RAI
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Credential | MS, LPC
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Telephone | 856-739-0402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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