Ava Luciana Berenato, LAC
Individual provider Active NPI Counselor · Park Ridge, NJ
NPI 1831994110 · NPPES record last updated Feb 19, 2025
Key facts
- NPI
- 1831994110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 37AC00825100 (NJ)
- Practice address
- 175 Kinderkamack Rd # 1042
Park Ridge, NJ 07656-1335 - Phone
- (856) 433-4397
- NPI assigned
- Feb 19, 2025
- 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 |
|---|---|---|---|
| 37AC00825100 | NJ | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37AC00825100 | NJ | Yes |
Addresses
Primary practice location
175 Kinderkamack Rd # 1042
Park Ridge, NJ 07656-1335
Mailing address
1525 Pine Ave
Voorhees, NJ 08043-3630
Phone (856) 298-6685
Other providers in Park Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2025. 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.