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General NPI Number Information
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NPI Number | 1902515570
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Entity Type | Individual
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Provider Name | SARINA RAE-KAUFFMAN PRICE LPC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 1 PROSPECT ST STE 5
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4440
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Country | US
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Telephone | 469-361-3239
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Fax |
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Provider Business Mailing Address
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Address Line | 38 BERWYN PL
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City | FAIR LAWN
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State | NJ
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Zip | 07410-3605
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Country | US
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Telephone | 914-420-1635
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00850700
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License Number State | NJ
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