Mjc Psychotherapy Services | |
622-624 Valley Road Suite 6c Upper Montclair NJ 07043 | |
(201) 704-3164 | |
(877) 615-7339 |
Full Name | Mjc Psychotherapy Services |
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Speciality | Social Worker |
Location | 622-624 Valley Road, Upper Montclair, New Jersey |
Authorized Official Name and Position | Mary K. Culley (OWNER/PROVIDER) |
Authorized Official Contact | 2017043164 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mjc Psychotherapy Services 622-624 Valley Road Suite 6c Upper Montclair NJ 07043 Ph: (201) 704-3164 | Mjc Psychotherapy Services 622-624 Valley Road Suite 6c Upper Montclair NJ 07043 Ph: (201) 704-3164 |
NPI Number | 1457949190 |
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Provider Enumeration Date | 01/07/2021 |
Last Update Date | 03/13/2023 |
Certification Date | 03/13/2023 |
Medicare PECOS PAC ID | 6406216928 |
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Medicare Enrollment ID | O20230716000087 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457949190 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Mary Culley |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467850586 PECOS PAC ID: 8426411216 Enrollment ID: I20230827000126 |
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