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NPI 1730996661

NPI 1730996661 : VITALITY & SERENITY COUNSELING LLC : ANNANDALE, NJ

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General NPI Number Information
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    NPI Number           |    1730996661
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    Entity Type          |    Organization 
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    Legal Business Name  |    VITALITY & SERENITY COUNSELING LLC 
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Dates
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    Enumeration Date     |    12/13/2024
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    Last Update Date     |    01/10/2025
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Provider Practice Location Address
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    Address Line         |    24 LANDSDOWN RD 
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    City                 |    ANNANDALE
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    State                |    NJ
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    Zip                  |    08801-3603
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    Country              |    US
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    Telephone            |    732-440-8963
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    24 LANDSDOWN RD 
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    City                 |    ANNANDALE
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    State                |    NJ
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    Zip                  |    08801-3603
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    Country              |    US
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    Telephone            |    732-440-8963
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     ANNIE  RUSSO 
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    Credential           |    
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    Telephone            |    732-440-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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