MEDICARE: NINA BIANCA ACUNA FRANCISCO LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37AC00860300	NJ

General Provider Information

NPI Number	:	1205788981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA BIANCA ACUNA FRANCISCO LAC

Provider Business Mailing Address
First Line	:	1060 MAIN ST STE 200
Second Line	:
City	:	RIVER EDGE
State	:	NJ
Zip	:	07661-2591
Country	:	US
Telephone Number	:	201-835-3333
Fax Number	:	201-322-0089

Provider Business Practice Location Address
First Line	:	1060 MAIN ST STE 200
Second Line	:
City	:	RIVER EDGE
State	:	NJ
Zip	:	07661-2591
Country	:	US
Telephone Number	:	201-835-3333
Fax Number	:	201-322-0089

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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