Provider Demographics
NPI:1225494339
Name:SANTANA, DENISSIE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:DENISSIE
Middle Name:
Last Name:SANTANA
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326A PLAZA RD N
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3640
Mailing Address - Country:US
Mailing Address - Phone:551-243-5303
Mailing Address - Fax:
Practice Address - Street 1:127 AYERS CT
Practice Address - Street 2:APT. E2
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5152
Practice Address - Country:US
Practice Address - Phone:201-923-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00285800101Y00000X
NJ37PC00658700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor