Provider Demographics
NPI:1568086361
Name:PALA, GULSUM C (LAC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GULSUM
Middle Name:C
Last Name:PALA
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CLINTON PL
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1723
Mailing Address - Country:US
Mailing Address - Phone:201-574-6652
Mailing Address - Fax:
Practice Address - Street 1:132 CLINTON PL
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1723
Practice Address - Country:US
Practice Address - Phone:201-574-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ632335101Y00000X
NJ37AC00489400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor