Carissa Ali, LAC
Individual provider Active NPI Mental Health Counselor · Freehold, NJ
NPI 1578043543 · NPPES record last updated Aug 18, 2018
Key facts
- NPI
- 1578043543
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 37AC00401400 (NJ)
- Practice address
- 3499 Route 9 N Ste 2C
Freehold, NJ 07728-3277 - Phone
- (732) 982-2888
- NPI assigned
- Aug 18, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 37AC00401400 | NJ | MD | Mental Health Counselor |
Interoperability endpoints
- lifestancehealth.carissaali@148376.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC00401400 | NJ | Yes |
Addresses
Primary practice location
3499 Route 9 N Ste 2C
Freehold, NJ 07728-3277
Mailing address
175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 737-8768
Other providers in Freehold, NJ
- Geronima G Alday
- Kristen Alestra
- Alexander Petcu MD LLC
- Carlyne Bonnie Alexander
- Joann Alfonzo
- All Be Healthy LLC
- Allaire Chiropractic, LLC
- Allaire Healthcare Group LLC
- Allaire Healthcare Group LLC
- Allan Burstein MD PA
All providers in Freehold, 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 Aug 18, 2018. 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.