Perry Rashiyd Bakari, LCADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Cherry Hill, NJ

NPI 1962092239 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1962092239
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
37LC00364700 (NJ)
Practice address
1080 Cornell Ave South
Building 6
Cherry Hill, NJ 08002
Phone
(856) 246-4744
Fax
(973) 571-8003
NPI assigned
Jan 21, 2021
Sex
Male
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

LicenseStateTypeSpecialty
37CA00165400NJMDAddiction (Substance Use Disorder) Counselor
37LC00364700NJMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37CA00165400 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00364700 NJ Yes

Addresses

Primary practice location

1080 Cornell Ave South
Building 6
Cherry Hill, NJ 08002

Mailing address

900 Easton Ave, PO Box 6617
Somerset, NJ 08875-6617
Phone (732) 246-1347

Other providers in Cherry Hill, NJ

All providers in Cherry Hill, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.