Individual provider · NPI-1

Vanessa Bonilla, LAC

Counselor, Mental Health · Hackensack, NJ

NPI number1073204061
StatusActive
Last updated in NPPESMay 19, 2023

Details

NPI
1073204061
Entity type
Individual (NPI-1)
Name
Vanessa Bonilla
Credential
LAC
Sex
Female
Sole proprietor
No
Enumeration date
May 19, 2023
Certification date
May 18, 2023
Last updated
May 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health37AC00468200NJYes

Practice location

25 E Salem St
Hackensack, NJ 07601-7427

Phone 201-933-8508

Mailing address

619 Schuyler Ave Apt 102
Lyndhurst, NJ 07071-2928

Phone 973-640-0245

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Counselor, Mental Health providers in Hackensack, NJ