Provider Demographics
NPI:1124785084
Name:SALEH, GHADA (MA, LPC)
Entity type:Individual
Prefix:
First Name:GHADA
Middle Name:
Last Name:SALEH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 VENTNOR CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2197
Mailing Address - Country:US
Mailing Address - Phone:267-946-9991
Mailing Address - Fax:
Practice Address - Street 1:121 CHANLON ROAD
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974
Practice Address - Country:US
Practice Address - Phone:267-946-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-25
Last Update Date:2024-11-18
Deactivation Date:2023-10-20
Deactivation Code:
Reactivation Date:2024-11-11
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00782300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional