Provider Demographics
NPI:1154186757
Name:ABDELAZIZ, NADINE (LAC, CCTP)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:ABDELAZIZ
Suffix:
Gender:F
Credentials:LAC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2810
Mailing Address - Country:US
Mailing Address - Phone:551-554-8700
Mailing Address - Fax:
Practice Address - Street 1:95 N STATE RT 17 STE 100
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2648
Practice Address - Country:US
Practice Address - Phone:732-978-9895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00772300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health