Individual provider · NPI-1

Bandele Addison, LPC

Counselor, Professional · Brick, NJ

NPI number1114342078
StatusActive
Last updated in NPPESFeb 28, 2014

Details

NPI
1114342078
Entity type
Individual (NPI-1)
Name
Bandele Addison
Credential
LPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 28, 2014
Last updated
Feb 28, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional37PC00491900NJYes

Practice location

522 Brick Blvd
Brick, NJ 08723-6089

Phone 973-432-0427

Mailing address

631m Madison Dr
Monroe Township, NJ 08831-5243

Phone 973-432-0427

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