Organization
ANYCOLOR WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKITA FONAREV LCSW (OWNER / PSYCHOTHERAPIST)
(347) 470-5199
Entity
Organization
Contact information
Practice address
20 RANDOLPH PL STE A, WEST ORANGE, NJ 07052-4808
(347) 668-0107
Mailing address
20 RANDOLPH PL STE A, WEST ORANGE, NJ 07052-4808
(347) 668-0107
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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