| Extensive Psychological Services,inc | |
|
20 Gibson Pl Ste 206 Freehold NJ 07728-4837 | |
| (732) 483-4425 | |
| (732) 483-4427 |
| Full Name | Extensive Psychological Services,inc |
|---|---|
| Speciality | Counselor |
| Location | 20 Gibson Pl Ste 206, Freehold, New Jersey |
| Authorized Official Name and Position | Carol Monaci Fahad (PRESIDENT) |
| Authorized Official Contact | 7329962863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Extensive Psychological Services,inc 20 Gibson Pl Ste 206 Freehold NJ 07728-4837 Ph: (732) 483-4425 | Extensive Psychological Services,inc 20 Gibson Pl Ste 206 Freehold NJ 07728-4837 Ph: (732) 483-4425 |
| NPI Number | 1346579109 |
|---|---|
| Provider Enumeration Date | 12/08/2009 |
| Last Update Date | 12/08/2009 |
| Medicare PECOS PAC ID | 1850579384 |
|---|---|
| Medicare Enrollment ID | O20110701000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346579109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00021400 (New Jersey) | Primary |
| Provider Name | Gail P Lovallo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134390180 PECOS PAC ID: 3971667445 Enrollment ID: I20090128000069 |
| Provider Name | Elizabeth C Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114297348 PECOS PAC ID: 3274753116 Enrollment ID: I20140929000175 |
| Provider Name | Eliezer Hilman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275805764 PECOS PAC ID: 0547564981 Enrollment ID: I20160205000882 |
| Provider Name | Sarina Mulleavey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083012918 PECOS PAC ID: 8022309525 Enrollment ID: I20160613002485 |
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