Provider Demographics
NPI:1952792483
Name:BHATT, SHALIN J (LPC, LCADC, NCC)
Entity Type:Individual
Prefix:MR
First Name:SHALIN
Middle Name:J
Last Name:BHATT
Suffix:
Gender:M
Credentials:LPC, LCADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RIVER ROAD, SUITE 32
Mailing Address - Street 2:#156
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1149
Mailing Address - Country:US
Mailing Address - Phone:551-325-4715
Mailing Address - Fax:
Practice Address - Street 1:323 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1824
Practice Address - Country:US
Practice Address - Phone:973-596-3414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00301400101YA0400X
NJ37PC00661000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)