MEDICARE: ACKEEM CARTO 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	101YP2500X	Professional Counselor	37PC01252100	NJ
2	101YP2500X	Professional Counselor	PC018627	PA

General Provider Information

NPI Number	:	1346027000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ACKEEM CARTO LAC

Provider Business Mailing Address
First Line	:	PO BOX 49
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-0049
Country	:	US
Telephone Number	:	800-413-8020
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 PASSAIC AVE STE 200
Second Line	:
City	:	FAIRFIELD
State	:	NJ
Zip	:	07004-3526
Country	:	US
Telephone Number	:	800-413-8020
Fax Number	:	732-479-6751

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

Provider Enumeration Date	:	09/14/2023
Last Update Date	:	04/28/2026

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Directions to “ ACKEEM CARTO LAC” Practice Location

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