MEDICARE: INNER LIGHT COUNSELING

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	37PC00377300	NJ
2	101YP2500X	Professional Counselor	37AC00027400	NJ
3	101YP2500X	Professional Counselor
4	101YP2500X	Professional Counselor	37PC00296600	NJ

General Provider Information

NPI Number	:	1720383821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER LIGHT COUNSELING

Provider Business Mailing Address
First Line	:	285 E MAIN ST
Second Line	:
City	:	SOMERVILLE
State	:	NJ
Zip	:	08876-3005
Country	:	US
Telephone Number	:	908-295-2007
Fax Number	:	908-707-8498

Provider Business Practice Location Address
First Line	:	285 E MAIN ST
Second Line	:
City	:	SOMERVILLE
State	:	NJ
Zip	:	08876-3005
Country	:	US
Telephone Number	:	908-295-2007
Fax Number	:	908-707-8498

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. MARIE SCODARI
Credential	:	LCSW
Telephone Number	:	908-295-2007

Provider Enumeration Date	:	01/20/2011
Last Update Date	:	01/20/2011

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Directions to “INNER LIGHT COUNSELING ” Practice Location

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