Provider Demographics
NPI:1235865148
Name:KUFEL, MARIOLA K (LPC)
Entity Type:Individual
Prefix:
First Name:MARIOLA
Middle Name:K
Last Name:KUFEL
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 1:208 DIVISION AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-3606
Mailing Address - Country:US
Mailing Address - Phone:201-456-4017
Mailing Address - Fax:
Practice Address - Street 1:78 JOHN MILLER WAY STE 307
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-6531
Practice Address - Country:US
Practice Address - Phone:201-456-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJK91225197257866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJK91225197257866OtherCOMMERCIAL INSURANCE