1992387765 NPI number — NGOC NHUNG T DALESSIO LPC, LCADC, ACS

Table of content: NGOC NHUNG T DALESSIO LPC, LCADC, ACS (NPI 1992387765)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992387765 NPI number — NGOC NHUNG T DALESSIO LPC, LCADC, ACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DALESSIO
Provider First Name:
NGOC NHUNG
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC, LCADC, ACS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NGUYEN
Provider Other First Name:
NIKKI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, LCADC, ACS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992387765
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 ROCK HOLLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07801-1617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-517-9033
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 RIVER STREET
Provider Second Line Business Practice Location Address:
9TH FLOOR
Provider Business Practice Location Address City Name:
HOBOKEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-370-5431
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  37LC00327700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 37PC00729600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)