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Organization
SECOND CHANCE MENTAL HEALTH COUNSELING
Active
Organization
SECOND CHANCE MENTAL HEALTH COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANSIMON ELIA BOTROUS REZK LPC (CLINICIAN)
(717) 475-2907
Entity
Organization
Contact information
Practice address
185 MAIN ST APT A, CLIFFSIDE PARK, NJ 07010-1249
(717) 475-2907
Mailing address
185 MAIN ST APT A, CLIFFSIDE PARK, NJ 07010-1249
(717) 475-2907
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548756687
NPI
NJ
Enumeration date
02/08/2024
Last updated
02/08/2024
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