Provider Demographics
NPI:1710320833
Name:MARQUEZ, LUISA (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5882
Mailing Address - Country:US
Mailing Address - Phone:201-749-2009
Mailing Address - Fax:201-749-2009
Practice Address - Street 1:375 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5882
Practice Address - Country:US
Practice Address - Phone:201-749-2009
Practice Address - Fax:201-749-2009
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00515000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health