Provider Demographics
NPI:1811384142
Name:MESSICK, DANA (MA, LPC, ACS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:MESSICK
Suffix:
Gender:F
Credentials:MA, LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3409
Mailing Address - Country:US
Mailing Address - Phone:908-355-7886
Mailing Address - Fax:973-383-8676
Practice Address - Street 1:93 STICKLES POND RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2813
Practice Address - Country:US
Practice Address - Phone:973-383-8670
Practice Address - Fax:973-383-8676
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00238500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional