Provider Demographics
NPI:1992245435
Name:GERALDES, ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GERALDES
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 1:205 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1349
Mailing Address - Country:US
Mailing Address - Phone:973-970-8180
Mailing Address - Fax:
Practice Address - Street 1:205 RIDGEDALE AVE STE 2
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1349
Practice Address - Country:US
Practice Address - Phone:973-970-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00353700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health