Individual
NANTUME KABANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCC-C
Contact information
Practice address
19 GRAND AVE # 1, NEWARK, NJ 07106-1223
(732) 874-0156
Mailing address
19 GRAND AVE # 1, NEWARK, NJ 07106-1223
(732) 874-0156
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
397129034
TX
101YP1600X
Pastoral Counselor
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123070526901
AETNA
—
05
—
NONE
—
NJ
Enumeration date
06/24/2020
Last updated
05/22/2025
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