| Archetype Psychological Services, Llc | |
|
444 Northfield Ave West Orange NJ 07052-3012 | |
| (646) 820-5477 | |
| Not Available |
| Full Name | Archetype Psychological Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 444 Northfield Ave, West Orange, New Jersey |
| Authorized Official Name and Position | Wendy Wilson-poth (OWNER) |
| Authorized Official Contact | 6468205477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Archetype Psychological Services, Llc 111 Allen St Netcong NJ 07857-1222 Ph: (973) 527-4464 | Archetype Psychological Services, Llc 444 Northfield Ave West Orange NJ 07052-3012 Ph: (646) 820-5477 |
| NPI Number | 1952964611 |
|---|---|
| Provider Enumeration Date | 04/18/2019 |
| Last Update Date | 04/18/2019 |
| Medicare PECOS PAC ID | 7517291842 |
|---|---|
| Medicare Enrollment ID | O20190620001376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952964611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Wendy Diane Wilson-poth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912439738 PECOS PAC ID: 7911274691 Enrollment ID: I20170531000872 |
Skyheart Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 145 Marion Dr, West Orange, NJ 07052 Phone: 973-486-4559 | |
Morgan Dream Foundation Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 68 William St, West Orange, NJ 07052 Phone: 973-731-6202 | |
Help For The Helper, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Northfield Ave, West Orange, NJ 07052 Phone: 973-736-4008 | |
Behavior Buzz Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Nestro Rd, West Orange, NJ 07052 Phone: 973-851-0890 | |
Whidbeyhealth Telehealth Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 67 Burnett Ter, West Orange, NJ 07052 Phone: 360-678-5151 Fax: 360-678-7676 | |
The Friendship Group, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Hillcrest Ave, West Orange, NJ 07052 Phone: 973-243-9111 | |
Children's Aid And Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 161 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-243-0212 Fax: 973-243-0214 |