Individual
SHEENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 1/2 9TH AVE, NEWARK, NJ 07107-1518
(917) 640-9075
Mailing address
104 SANFORD PL, NEWARK, NJ 07106-3316
(917) 640-9075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
37AC00690300
NJ
101YP2500X
Professional Counselor
Primary
37PC01019000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300838743
—
NJ
Enumeration date
06/28/2022
Last updated
04/24/2024
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