Individual
MARKIM SHAKUR-PURVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
183 S ORANGE AVE, NEWARK, NJ 07103-2757
(973) 972-0478
Mailing address
201A BUCKINGHAM DR, LAKEWOOD, NJ 08701-7806
(732) 682-4343
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00160000
NJ
101YP2500X
Professional Counselor
Primary
37PC00471600
NJ
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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