| Integrated Counseling Services | |
|
321 79th St North Bergen NJ 07047-5644 | |
| (917) 364-0303 | |
| Not Available |
| Full Name | Integrated Counseling Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 321 79th St, North Bergen, New Jersey |
| Authorized Official Name and Position | Juan J Almanzar (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9173640303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Counseling Services 321 79th St North Bergen NJ 07047-5644 Ph: (917) 364-0303 | Integrated Counseling Services 321 79th St North Bergen NJ 07047-5644 Ph: (917) 364-0303 |
| NPI Number | 1407462179 |
|---|---|
| Provider Enumeration Date | 09/18/2020 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Medicare PECOS PAC ID | 0840726378 |
|---|---|
| Medicare Enrollment ID | O20241209000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407462179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Juan Almanzar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982707899 PECOS PAC ID: 8224284765 Enrollment ID: I20210708003523 |
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