Kathleen Azzaro, LPC
Individual provider Active NPI Mental Health Counselor · Bergenfield, NJ
NPI 1407446982 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1407446982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 37PC00483500 (NJ)
- Practice address
- 165 Vreeland Ave
Bergenfield, NJ 07621-1930 - Phone
- (201) 390-7041
- NPI assigned
- Jan 19, 2021
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00483500 | NJ | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37PC00483500 | NJ | Yes |
Addresses
Primary practice location
165 Vreeland Ave
Bergenfield, NJ 07621-1930
Mailing address
165 Vreeland Ave
Bergenfield, NJ 07621-1930
Phone (201) 390-7041
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All providers in Bergenfield, NJ · Mental Health Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.