Provider Demographics
NPI:1720483613
Name:YESSENIA GUGLIELMI, LLC
Entity Type:Organization
Organization Name:YESSENIA GUGLIELMI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YESSENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUGLIELMI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-230-5685
Mailing Address - Street 1:147 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2113
Mailing Address - Country:US
Mailing Address - Phone:201-230-5685
Mailing Address - Fax:973-236-0030
Practice Address - Street 1:147 COLUMBIA TPKE
Practice Address - Street 2:SUITE 307
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2113
Practice Address - Country:US
Practice Address - Phone:201-230-5685
Practice Address - Fax:973-236-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00309800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty