Provider Demographics
NPI:1548801947
Name:SUAREZ, ENMANUEL (LPC)
Entity Type:Individual
Prefix:
First Name:ENMANUEL
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1717
Mailing Address - Country:US
Mailing Address - Phone:813-928-3349
Mailing Address - Fax:
Practice Address - Street 1:5 REGENT ST STE 518
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1682
Practice Address - Country:US
Practice Address - Phone:813-928-3349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00691800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional