Provider Demographics
NPI:1982111076
Name:CZACHOROWSKI, DANA (LPC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CZACHOROWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 JOERG AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1053
Mailing Address - Country:US
Mailing Address - Phone:201-467-1652
Mailing Address - Fax:
Practice Address - Street 1:841 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3814
Practice Address - Country:US
Practice Address - Phone:201-467-1652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00621500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional