| Irvington Counseling Center, Inc. | |
|
21-29 Wagner Place Irvington NJ 07111 | |
| (973) 399-3132 | |
| (973) 399-7552 |
| Full Name | Irvington Counseling Center, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 21-29 Wagner Place, Irvington, New Jersey |
| Authorized Official Name and Position | Norma Anne Hanson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9733993132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irvington Counseling Center, Inc. 21-29 Wagner Place Irvington NJ 07111 Ph: (973) 399-3132 | Irvington Counseling Center, Inc. 21-29 Wagner Place Irvington NJ 07111 Ph: (973) 399-3132 |
| NPI Number | 1356377113 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8921137274 |
|---|---|
| Medicare Enrollment ID | O20100525000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356377113 | NPI | - | NPPES |
| 0007803 | Medicaid | NJ |
| Provider Name | Anwar Y Ghali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093787145 PECOS PAC ID: 9739130816 Enrollment ID: I20050207000166 |
| Provider Name | Christine Reyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417064908 PECOS PAC ID: 2769662063 Enrollment ID: I20111221000365 |
| Provider Name | Laura L Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861758104 PECOS PAC ID: 0345505269 Enrollment ID: I20180524001655 |
| Provider Name | Raywatie S Gocool |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588159511 PECOS PAC ID: 5193056828 Enrollment ID: I20191011000115 |
| Provider Name | Femi Omidire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235760984 PECOS PAC ID: 1153744602 Enrollment ID: I20200701000600 |
| Provider Name | Prisca U Ogbonnaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164140083 PECOS PAC ID: 6204285117 Enrollment ID: I20231218000376 |
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