Provider Demographics
NPI:1861295248
Name:ALI, AL-AMIN SIDDIQ (MA,LCADC,CCS)
Entity type:Individual
Prefix:MR
First Name:AL-AMIN
Middle Name:SIDDIQ
Last Name:ALI
Suffix:
Gender:
Credentials:MA,LCADC,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 CONVENTRY CT
Mailing Address - Street 2:NA
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2988
Mailing Address - Country:US
Mailing Address - Phone:973-699-1171
Mailing Address - Fax:
Practice Address - Street 1:1414 CONVENTRY CT
Practice Address - Street 2:NA
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2988
Practice Address - Country:US
Practice Address - Phone:973-699-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)