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General NPI Number Information
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NPI Number | 1528721651
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Entity Type | Individual
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Provider Name | JERI FATIA MENTOR LPC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 132 PERRY ST
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City | TRENTON
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State | NJ
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Zip | 08618-3968
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Country | US
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Telephone | 609-394-8988
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Fax | 609-394-0023
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 732-908-6352
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 37LC00328700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00867400
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License Number State | NJ
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