Provider Demographics
NPI:1205187176
Name:AKPAN, EMMANUEL (PHD,)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:
Last Name:AKPAN
Suffix:
Gender:M
Credentials:PHD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-9737
Mailing Address - Country:US
Mailing Address - Phone:973-584-6700
Mailing Address - Fax:973-584-4991
Practice Address - Street 1:1278 ROUTE 46
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852-9737
Practice Address - Country:US
Practice Address - Phone:973-584-6700
Practice Address - Fax:973-584-4991
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC0006300101YA0400X
NJ37AC00063800101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral