Organization
REVEAL TO HEAL CONSULTING A NJ NON PROFIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA BRADLEY (EXECUTIVE DIRETOR)
(862) 371-4463
Entity
Organization
Contact information
Practice address
2115 MILLBURN AVE LOWR LEVEL2, MAPLEWOOD, NJ 07040-3724
(863) 371-4463
Mailing address
64 LENOX STREET, NEWARK, NJ 07106
(862) 371-4463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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