Provider Demographics
NPI:1043058852
Name:VISCOMI, CATERINA A (LPC, LICENSED COACH)
Entity type:Individual
Prefix:
First Name:CATERINA
Middle Name:A
Last Name:VISCOMI
Suffix:
Gender:F
Credentials:LPC, LICENSED COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 VREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1761
Mailing Address - Country:US
Mailing Address - Phone:973-235-1212
Mailing Address - Fax:
Practice Address - Street 1:145 VREELAND AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1761
Practice Address - Country:US
Practice Address - Phone:973-235-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01035000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty