Individual
KSANTI MARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
24 BEAVER RIDGE RD, MORRIS PLAINS, NJ 07950-1901
(615) 430-5746
Mailing address
24 BEAVER RIDGE RD, MORRIS PLAINS, NJ 07950-1901
(615) 430-5746
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37PC00619100
NJ
101YP2500X
Professional Counselor
Primary
LPC1736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00619100
NJ LPC LICENSE
NJ
01
—
89505
NBCC NATIONAL LICENSE
—
01
—
LPC1736
TN LPC LICENSE
TN
Enumeration date
08/23/2006
Last updated
02/24/2022
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