Organization
YOUR FAVORITE THERAPIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVYNTE PANNELL MA, LPC (CEO)
(973) 327-3134
Entity
Organization
Contact information
Practice address
2 FEDERAL SQ, NEWARK, NJ 07101-2901
(301) 848-9608
Mailing address
PO BOX 20380, NEWARK, NJ 07101-6380
(973) 327-3134
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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