| Core Counseling Of North Jersey, Llc | |
|
40 N Van Brunt St Englewood NJ 07631-2740 | |
| (201) 875-5699 | |
| (201) 503-2345 |
| Full Name | Core Counseling Of North Jersey, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 40 N Van Brunt St, Englewood, New Jersey |
| Authorized Official Name and Position | Lisa Fedder (MANAGING PARTNER/ PSYCHOTHERAPIST) |
| Authorized Official Contact | 2018755699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Counseling Of North Jersey, Llc 40 N Van Brunt St Englewood NJ 07631-2740 Ph: (201) 875-5699 | Core Counseling Of North Jersey, Llc 40 N Van Brunt St Englewood NJ 07631-2740 Ph: (201) 875-5699 |
| NPI Number | 1295371243 |
|---|---|
| Provider Enumeration Date | 11/25/2019 |
| Last Update Date | 07/20/2020 |
| Certification Date | 07/20/2020 |
| Medicare PECOS PAC ID | 5496171399 |
|---|---|
| Medicare Enrollment ID | O20200821000768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295371243 | NPI | - | NPPES |
| Provider Name | Nadine Gardner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871547687 PECOS PAC ID: 6204923030 Enrollment ID: I20180914000072 |
| Provider Name | Nicholas Repice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104291038 PECOS PAC ID: 4385067701 Enrollment ID: I20200701003088 |
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