=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487457669
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY & LIFE SKILLS COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2025
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 436 VALLEY BROOK AVE
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-6600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-298-3127
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 402
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-0402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 12-983-1272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOTHERAPIST
-----------------------------------------------------
Name | MARTIMA SIMS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 201-618-8346
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------