Individual provider · NPI-1

John D Avella, LPC NCC NJSP DRCC

Counselor, Professional · Brick, NJ

NPI number1063846582
StatusActive
Last updated in NPPESNov 15, 2016

Details

NPI
1063846582
Entity type
Individual (NPI-1)
Name
John D Avella
Credential
LPC NCC NJSP DRCC
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 3, 2013
Last updated
Nov 15, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional37PC00152000NJYes

Practice location

74 Brick Blvd
Suite 206b
Brick, NJ 08723-7984

Phone 732-477-0862 · Fax 732-477-0879

Mailing address

74 Brick Blvd
Suite 206b
Brick, NJ 08723-7984

Phone 732-477-0862 · Fax 732-477-0879

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