Carol Anne Evangelisto

Individual provider Active NPI Professional Counselor · Allentown, NJ

NPI 1043716236 · NPPES record last updated Apr 5, 2018

Key facts

NPI
1043716236
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
37PC00135300 (NJ)
Practice address
3 S Main St
Allentown, NJ 08501-1683
Phone
(609) 208-3053
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
37PC00135300NJMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00135300 NJ Yes

Addresses

Primary practice location

3 S Main St
Allentown, NJ 08501-1683

Mailing address

16 Hilton CT
Pennington, NJ 08534-1959
Phone (609) 730-9422

Other providers in Allentown, NJ

All providers in Allentown, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.