| Nutley Family Service Bureau, Inc. | |
|
155 Chestnut St Nutley NJ 07110-2311 | |
| (973) 667-1884 | |
| (973) 667-2285 |
| Full Name | Nutley Family Service Bureau, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 155 Chestnut St, Nutley, New Jersey |
| Authorized Official Name and Position | Katherine Carmichael (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9736671884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nutley Family Service Bureau, Inc. 169 Chestnut St Nutley NJ 07110-2311 Ph: (973) 667-1884 | Nutley Family Service Bureau, Inc. 155 Chestnut St Nutley NJ 07110-2311 Ph: (973) 667-1884 |
| NPI Number | 1760532345 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Medicare PECOS PAC ID | 4880866482 |
|---|---|
| Medicare Enrollment ID | O20111004000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760532345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
| Provider Name | Carmen Ostow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689738635 PECOS PAC ID: 0840255378 Enrollment ID: I20041124000182 |
| Provider Name | Raymond Chong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720239023 PECOS PAC ID: 7315136249 Enrollment ID: I20110107000701 |
| Provider Name | Staela Keegan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578786430 PECOS PAC ID: 2860679404 Enrollment ID: I20110607000569 |
| Provider Name | Linda M Tanks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255509824 PECOS PAC ID: 3375714397 Enrollment ID: I20110923000499 |
| Provider Name | Patricia Politi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134436587 PECOS PAC ID: 8426343971 Enrollment ID: I20160823000393 |
| Provider Name | Johanna W Rosenfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740645472 PECOS PAC ID: 5294064028 Enrollment ID: I20190904001557 |
| Provider Name | Femi Omidire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235760984 PECOS PAC ID: 1153744602 Enrollment ID: I20200701000600 |
| Provider Name | Regina E Fitch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831505114 PECOS PAC ID: 6800219908 Enrollment ID: I20200708001663 |
| Provider Name | Kelly Rivadeneyra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790242469 PECOS PAC ID: 4587072103 Enrollment ID: I20210421000313 |
| Provider Name | Kristen Petullo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952540858 PECOS PAC ID: 9234516543 Enrollment ID: I20220506000226 |
| Provider Name | Kathleen M Cheski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205111648 PECOS PAC ID: 5395900237 Enrollment ID: I20230119002799 |
| Provider Name | Eman Lordi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437513900 PECOS PAC ID: 8921473752 Enrollment ID: I20230410002157 |
| Provider Name | Kerry E Mccann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467041905 PECOS PAC ID: 1658717129 Enrollment ID: I20240307001341 |
| Provider Name | Laura Patricia Munoz-torres |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376133546 PECOS PAC ID: 6103263413 Enrollment ID: I20240322000400 |
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