Provider Demographics
NPI:1588038582
Name:BARAKA, NIYA (LPC, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:NIYA
Middle Name:
Last Name:BARAKA
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 EVERGREEN RD
Mailing Address - Street 2:APT. 19B
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2445
Mailing Address - Country:US
Mailing Address - Phone:973-698-2364
Mailing Address - Fax:
Practice Address - Street 1:172 EVERGREEN RD
Practice Address - Street 2:APT. 19B
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2445
Practice Address - Country:US
Practice Address - Phone:973-698-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-15
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00191700101YA0400X
NJ37PC00612200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)