| Bergen Psychotherapy & Community Outreach, Llc | |
|
901 Teaneck Rd Teaneck NJ 07666-4511 | |
| (201) 357-2714 | |
| Not Available |
| Full Name | Bergen Psychotherapy & Community Outreach, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 901 Teaneck Rd, Teaneck, New Jersey |
| Authorized Official Name and Position | Alida A. Dominianni (DIRECTOR) |
| Authorized Official Contact | 2018338838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Psychotherapy & Community Outreach, Llc 901 Teaneck Rd Teaneck NJ 07666-4511 Ph: (201) 357-2714 | Bergen Psychotherapy & Community Outreach, Llc 901 Teaneck Rd Teaneck NJ 07666-4511 Ph: (201) 357-2714 |
| NPI Number | 1659541324 |
|---|---|
| Provider Enumeration Date | 03/09/2008 |
| Last Update Date | 03/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659541324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05249200 (New Jersey) | Primary |
| 1041C0700X | Social Worker - Clinical | 44SC05322900 (New Jersey) | Secondary |
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