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Provider Information for 1790164622


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JANON WILSON LPC


Sex: Female

NPI: 1790164622
Last Updated: 2021-06-17
Certification Date: 2021-06-17

Details

NameValue
NPI1790164622
Enumeration Date2015-05-26
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 10 BANTA PL STE 107
HACKENSACK, NJ 07601-5605
United States

Phone: 973-259-8557 | Fax:973-532-6961
 
Primary Practice Address 10 BANTA PL STE 107
HACKENSACK, NJ 07601-5605
United States

Phone: 973-259-8557 | Fax:973-532-6961
 
Secondary Practice Address(es)

10 BANTA PL STE 107
HACKENSACK, NJ 07601-5605
United States

Phone: 973-259-8557 | Fax:973-532-6961
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
CONNECT URL
www.compasscounselingpsych.com
Website
Direct CSV 10 Banta Pl Ste 107
Hackensack, NJ 07601-5605
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalNJ37PC00503200