Individual provider · Type 1 NPI
Ellyn Alfonso, MA, LAC
Mental Health Counselor · Fair Lawn, NJ
NPI number
1669961553
Active
Practice location
17-07 Romaine St
Fair Lawn, NJ 07410-2150
Mailing address
54 Clifton Blvd
Clifton, NJ 07011-3814
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 37AC00262300 (NJ) |
Mental Health Counselor: Definition to come...
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About NPI 1669961553
Ellyn Alfonso, MA, LAC's National Provider Identifier is 1669961553, issued on May 7, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fair Lawn, NJ. The record was last updated on May 7, 2018.