Provider Demographics
NPI:1093313389
Name:KUIJLAARS, GINA (LPC, CCFC, CCATP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:KUIJLAARS
Suffix:
Gender:F
Credentials:LPC, CCFC, CCATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 VALLEY RD STE 2C
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1346
Mailing Address - Country:US
Mailing Address - Phone:908-963-9607
Mailing Address - Fax:
Practice Address - Street 1:1390 VALLEY RD STE 2C
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1346
Practice Address - Country:US
Practice Address - Phone:908-963-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00024000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional