Provider Demographics
NPI:1922634328
Name:SANTOS, JOANNA DOS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:DOS
Last Name:SANTOS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ANN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3109
Mailing Address - Country:US
Mailing Address - Phone:908-244-8889
Mailing Address - Fax:
Practice Address - Street 1:147 COLUMBIA TPKE STE 307
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2145
Practice Address - Country:US
Practice Address - Phone:908-244-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00710700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty