Individual
ALEXIS MEGAN MARDOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, ATR-BC
Contact information
Practice address
113 STATE RT 284, SUSSEX, NJ 07461-3414
(973) 294-6339
Mailing address
113 STATE RT 284, SUSSEX, NJ 07461-3414
(973) 294-6339
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00747600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00747600
COUNSELOR
NJ
Enumeration date
06/07/2021
Last updated
06/07/2021
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