Provider Demographics
NPI:1417598418
Name:INTERNATIONAL ADVISERS CONSULTANT
Entity type:Organization
Organization Name:INTERNATIONAL ADVISERS CONSULTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR PASTOR / REVEREND
Authorized Official - Prefix:
Authorized Official - First Name:NANTUME
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:KABANDA
Authorized Official - Suffix:
Authorized Official - Credentials:RELIGIOUS NON-MEDICA
Authorized Official - Phone:732-874-0156
Mailing Address - Street 1:19 GRAND AVE # 1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-1223
Mailing Address - Country:US
Mailing Address - Phone:732-874-0156
Mailing Address - Fax:
Practice Address - Street 1:19 GRAND AVE # 1
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-1223
Practice Address - Country:US
Practice Address - Phone:732-874-0156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ10012019457229Medicaid
MA10012019457229Medicaid
NJNONEOtherNONE
1417598418OtherNOT YET
GA10012019457229Medicaid