CANDACE ANN BOLTUCH-FAGAN LPC;LCADC
NPI 1760577266
Counselor - Professional in Fort Lee, NJ
- Individual
- Female
- Counselor
- Professional
About CANDACE BOLTUCH-FAGAN
This page provides the complete NPI Profile along with additional information for Candace Boltuch-fagan, a provider established in Fort Lee, New Jersey with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1760577266 assigned on October 2006. The practitioner's primary taxonomy code is 101YP2500X with license number 0551 (NJ). The provider is registered as an individual and her NPI record was last updated 19 years ago.
- NPI
- 1760577266 Verify this NPI
- Provider Name
- CANDACE ANN BOLTUCH-FAGAN LPC;LCADC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2357 LEMOINE AVE FORT LEE, NJ 07024
- Location Phone
- (201) 585-9814
- Mailing Address
- 177 COLONIAL RD EMERSON, NJ 07630
- Mailing Phone
- (201) 986-7478
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-03-2006
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 0551
- License State
- NJ
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
FORT LEE, NJ 07024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760577266, enumerated as an "individual" on October 03, 2006.
The provider is located at 2357 LEMOINE AVE FORT LEE, NJ 07024 and the phone number is (201) 585-9814.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
