Glorious Ali Shabazz
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Paterson, NJ
NPI 1851922397 · NPPES record last updated Feb 3, 2020
Key facts
- NPI
- 1851922397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 37LC00280000 (NJ)
- Practice address
- 300 E 29TH St
Paterson, NJ 07514-1818 - Phone
- (973) 930-0044
- NPI assigned
- Feb 3, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adult Family Health Services LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00280000 | NJ | Yes |
Addresses
Primary practice location
300 E 29TH St
Paterson, NJ 07514-1818
Mailing address
300 E 29TH St
Paterson, NJ 07514-1818
Phone (973) 930-0044
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | other | Other |
Other providers in Paterson, NJ
- Wanda Lynn Sermon
- Georgina Maria Sesana
- Monique G. Severe
- Rehan Hassanin Seyam
- Donald Sgroi
- Nichol Shabazz
- Fady Fawzy Shafeek
- Abhi Shah
- Bindesh Kiran Shah
- Dinesh H Shah
All providers in Paterson, NJ · Addiction (Substance Use Disorder) 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 Feb 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.