Provider Demographics
NPI:1114463999
Name:DOSHI, POONAM V (LPC, NCC, CCMHC)
Entity Type:Individual
Prefix:MRS
First Name:POONAM
Middle Name:V
Last Name:DOSHI
Suffix:
Gender:F
Credentials:LPC, NCC, CCMHC
Other - Prefix:MS
Other - First Name:POONAM
Other - Middle Name:R
Other - Last Name:NAGDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:610, VALLEY HEALTH PLAZA
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-265-8200
Mailing Address - Fax:
Practice Address - Street 1:610 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3607
Practice Address - Country:US
Practice Address - Phone:201-265-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00551400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional