| Modern Therapy, Llc | |
|
1 Main St Ste 314 Eatontown NJ 07724-3905 | |
| (800) 605-0612 | |
| (800) 605-0612 |
| Full Name | Modern Therapy, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1 Main St Ste 314, Eatontown, New Jersey |
| Authorized Official Name and Position | Brandon Christensen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7325857814 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Therapy, Llc 1 Main St Ste 314 Eatontown NJ 07724-3905 Ph: (800) 605-0612 | Modern Therapy, Llc 1 Main St Ste 314 Eatontown NJ 07724-3905 Ph: (800) 605-0612 |
| NPI Number | 1861910747 |
|---|---|
| Provider Enumeration Date | 08/31/2017 |
| Last Update Date | 12/28/2021 |
| Certification Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861910747 | NPI | - | NPPES |
| 0450193127 | Other | NJ | OUT OF NETWORK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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