Organization
ESTHER LEGACY COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOHANNY C VALDERRAMA (LICENSED CLINICAL SOCIAL WORKER)
(201) 562-8931
Entity
Organization
Contact information
Practice address
121 CEDAR LN, TEANECK, NJ 07666-4457
(201) 429-5081
Mailing address
39 E 9TH ST, CLIFTON, NJ 07011-1107
(201) 562-8931
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NJ
261QM0850X
Adult Mental Health Clinic/Center
Primary
44SC05657400
NJ
Other
Enumeration date
11/21/2017
Last updated
12/19/2017
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