Individual
IGNACIO PERICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LAC, LCADC, NCC
Contact information
Practice address
596 ANDERSON AVE STE 305, CLIFFSIDE PARK, NJ 07010-1888
(201) 654-4086
Mailing address
540 38TH ST, UNION CITY, NJ 07087-2517
(201) 598-4344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00373100
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
37AC00661000
NJ
Other
Enumeration date
11/09/2021
Last updated
06/01/2024
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