| Acm Therapy Llc | |
|
362 Main St Wyckoff NJ 07481-1928 | |
| (201) 421-8789 | |
| Not Available |
| Full Name | Acm Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 362 Main St, Wyckoff, New Jersey |
| Authorized Official Name and Position | Ailyn Costa-minch (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2014218789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acm Therapy Llc 95 Mary Ann Ln Wyckoff NJ 07481-3138 Ph: (201) 421-8789 | Acm Therapy Llc 362 Main St Wyckoff NJ 07481-1928 Ph: (201) 421-8789 |
| NPI Number | 1659045896 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Medicare PECOS PAC ID | 9032515622 |
|---|---|
| Medicare Enrollment ID | O20210907003130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659045896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ailyn Y Costa Minch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558703215 PECOS PAC ID: 2264832559 Enrollment ID: I20210608001214 |
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