Provider Demographics
NPI:1831662659
Name:KAUR DHANJAL, DEEPJOT (MED, LAC)
Entity Type:Individual
Prefix:
First Name:DEEPJOT
Middle Name:
Last Name:KAUR DHANJAL
Suffix:
Gender:F
Credentials:MED, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GETTY AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2161
Mailing Address - Country:US
Mailing Address - Phone:201-665-3066
Mailing Address - Fax:
Practice Address - Street 1:600 GETTY AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2161
Practice Address - Country:US
Practice Address - Phone:201-665-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health