| Legend Psych Llc | |
|
550 Kinderkamack Rd Ste 108 Oradell NJ 07649-1500 | |
| (201) 523-4113 | |
| Not Available |
| Full Name | Legend Psych Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 550 Kinderkamack Rd Ste 108, Oradell, New Jersey |
| Authorized Official Name and Position | Blake W Jonas (OWNER) |
| Authorized Official Contact | 2015234113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legend Psych Llc 239 Prospect Ave Apt 1 New Milford NJ 07646-1764 Ph: (201) 523-4113 | Legend Psych Llc 550 Kinderkamack Rd Ste 108 Oradell NJ 07649-1500 Ph: (201) 523-4113 |
| NPI Number | 1114519360 |
|---|---|
| Provider Enumeration Date | 02/09/2021 |
| Last Update Date | 05/27/2021 |
| Certification Date | 05/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114519360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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