Provider Demographics
NPI:1346088648
Name:SANTANGELO, GRACE (MA, LAC, NCC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SANTANGELO
Suffix:
Gender:F
Credentials:MA, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-1023
Mailing Address - Country:US
Mailing Address - Phone:973-876-1772
Mailing Address - Fax:
Practice Address - Street 1:1259 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4913
Practice Address - Country:US
Practice Address - Phone:973-299-9919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00798200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health