Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Avicenna Medical Group, LLC

Organization Mental Health Counselor · NPI 1194067959

Avicenna Medical Group, LLC is a Mental Health Counselor in West Orange, New Jersey. Licensed in New Jersey. Registered with an NPI since 2013.

Licensed in
NJ
In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

414 Eagle Rock Ave Ste 307
West Orange, NJ 07052-4224
Phone: (646) 464-3110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 25MB07627000 (NJ)

Record details

NPI number1194067959
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fadi Samaan — Manager · (646) 464-3110
NPI enumeratedMarch 20, 2013
Last updated in NPPESMarch 22, 2013
Mailing address414 Eagle Rock Ave, Suite 307, West Orange, NJ 07052-4224

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