Provider Demographics
NPI:1265185250
Name:ADORNO, ANIESH M (LAC)
Entity type:Individual
Prefix:
First Name:ANIESH
Middle Name:M
Last Name:ADORNO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GLENWOOD AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1065
Mailing Address - Country:US
Mailing Address - Phone:862-272-1986
Mailing Address - Fax:
Practice Address - Street 1:7 GLENWOOD AVE STE 406
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1065
Practice Address - Country:US
Practice Address - Phone:862-272-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health