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General NPI Number Information
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NPI Number | 1770731788
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Entity Type | Organization
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Legal Business Name | RADIOTIS COUNSELING LLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 360 SPRINGFIELD AVE SUITE 301
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City | SUMMIT
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State | NJ
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Zip | 07901-4608
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Country | US
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Telephone | 973-270-5187
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Fax |
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Provider Business Mailing Address
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Address Line | 17A DOREMUS ST
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City | SUMMIT
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State | NJ
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Zip | 07901-3416
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Country | US
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Telephone | 201-874-2366
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. DEJAYE RADIOTIS
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Credential | LPC, NCC
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Telephone | 973-270-5187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37PC00326200
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License Number State | NJ
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