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

LicenseStateTypeSpecialty
37PC00483500NJMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Bergenfield, NJ

All providers in Bergenfield, NJ · Mental Health Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.