Provider Demographics
NPI:1942751581
Name:DELLA PENNA, JOHN J (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:DELLA PENNA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1711
Mailing Address - Country:US
Mailing Address - Phone:862-666-0411
Mailing Address - Fax:
Practice Address - Street 1:301 S LIVINGSTON AVE
Practice Address - Street 2:2ND FLOOR, SUITE 205
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3932
Practice Address - Country:US
Practice Address - Phone:862-666-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00552400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional