Provider Demographics
NPI:1538407887
Name:NADAL LINARES, ELIZABETH (LCADC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:NADAL LINARES
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:NADAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCADC
Mailing Address - Street 1:1492 MORRIS AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6343
Mailing Address - Country:US
Mailing Address - Phone:908-400-8463
Mailing Address - Fax:908-242-5042
Practice Address - Street 1:1492 MORRIS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6343
Practice Address - Country:US
Practice Address - Phone:908-400-8463
Practice Address - Fax:908-242-5042
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00173900101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
12445704OtherCAQH