Provider Demographics
NPI:1861374613
Name:MUSTAFA, WAJIHA (LAC)
Entity type:Individual
Prefix:
First Name:WAJIHA
Middle Name:
Last Name:MUSTAFA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 SHAW ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2163
Mailing Address - Country:US
Mailing Address - Phone:347-761-2276
Mailing Address - Fax:
Practice Address - Street 1:166 SHAW ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2163
Practice Address - Country:US
Practice Address - Phone:347-761-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health