MEDICARE: MARJORIE IZAGUIRRE MA, LPC, NCC

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	37PC01030700	NJ

General Provider Information

NPI Number	:	1598588055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE IZAGUIRRE MA, LPC, NCC

Provider Business Mailing Address
First Line	:	404 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2614
Country	:	US
Telephone Number	:	973-478-4444
Fax Number	:

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

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/04/2024

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