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General NPI Number Information
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NPI Number | 1699185645
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Entity Type | Individual
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Provider Name | PATRICIA AUSSEM
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Gender | Female
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 57 MAIN ST SUITE 207
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City | CHESTER
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State | NJ
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Zip | 07930-2582
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Country | US
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Telephone | 973-476-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 10 WILLISON PARK RD
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City | MORRISTOWN
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State | NJ
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Zip | 07960-2694
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005552-1
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License Number State | NY
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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 | 37PC00486600
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License Number State | NJ
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