Individual
YUSUF NATHANIEL SHAHEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
2130 MILLBURN AVE STE D1, MAPLEWOOD, NJ 07040-3749
(973) 763-8123
Mailing address
61 HOBSON ST FL 2, NEWARK, NJ 07112-1308
(973) 763-8123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00208500
PROFESSIONAL LICENSE
NJ
Enumeration date
07/31/2020
Last updated
07/31/2020
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