Provider Demographics
NPI:1730498155
Name:LEITE, NOELIA (LMFT)
Entity Type:Individual
Prefix:
First Name:NOELIA
Middle Name:
Last Name:LEITE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 RIVER DELL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2300
Mailing Address - Country:US
Mailing Address - Phone:201-786-3335
Mailing Address - Fax:
Practice Address - Street 1:120 CHESTNUT
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2500
Practice Address - Country:US
Practice Address - Phone:201-444-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00166200106H00000X
FLMT2511106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist