MEDICARE: PHYLLIS AMA DARKWA

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		NJ
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1447628102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLLIS AMA DARKWA

Provider Business Mailing Address
First Line	:	180 TALMADGE RD # 245
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2860
Country	:	US
Telephone Number	:	732-259-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 TALMADGE RD # 245
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2860
Country	:	US
Telephone Number	:	732-259-0566
Fax Number	:

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

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	04/07/2026

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Directions to “ PHYLLIS AMA DARKWA ” Practice Location

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