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Individual

MS. NANCY L DOUGLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, LCADC, NCC

Contact information

Practice address
191 W PORTAL RD, ASBURY, NJ 08802-1136
(908) 391-2859
Mailing address
191 W PORTAL RD, ASBURY, NJ 08802-1136
(908) 391-2859

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00185300
NJ
101YP2500X
Professional Counselor
Primary
37PC00443300
NJ

Other

Enumeration date
03/12/2012
Last updated
05/19/2012
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