Provider Demographics
NPI:1609654383
Name:BADRINATH, ANJALI (LAC)
Entity Type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:BADRINATH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 QUAKERBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1006
Mailing Address - Country:US
Mailing Address - Phone:856-354-0664
Mailing Address - Fax:
Practice Address - Street 1:3836 QUAKERBRIDGE RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1006
Practice Address - Country:US
Practice Address - Phone:856-354-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00727400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health