Provider Demographics
NPI:1467235606
Name:DEL VALLE, CELISSE M (LAC, LPCA)
Entity Type:Individual
Prefix:
First Name:CELISSE
Middle Name:M
Last Name:DEL VALLE
Suffix:
Gender:F
Credentials:LAC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 FAULKNER DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1608
Mailing Address - Country:US
Mailing Address - Phone:908-923-1085
Mailing Address - Fax:
Practice Address - Street 1:10 LANIDEX PLZ W STE 120
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-0221
Practice Address - Country:US
Practice Address - Phone:862-356-6059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6622101YM0800X
NJ37AC00739500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health