| Pascack Mental Health Center | |
|
114 Kinderkamack Road Park Ridge NJ 07656-2126 | |
| (201) 391-1355 | |
| (201) 391-9516 |
| Full Name | Pascack Mental Health Center |
|---|---|
| Speciality | Counselor |
| Location | 114 Kinderkamack Road, Park Ridge, New Jersey |
| Authorized Official Name and Position | Jorge Becerra (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2013911355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pascack Mental Health Center Po Box 126 114 Kinderkamack Road Park Ridge NJ 07656-2126 Ph: (201) 391-1355 | Pascack Mental Health Center 114 Kinderkamack Road Park Ridge NJ 07656-2126 Ph: (201) 391-1355 |
| NPI Number | 1154526440 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 10/16/2007 |
| Medicare PECOS PAC ID | 0042300311 |
|---|---|
| Medicare Enrollment ID | O20071227000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154526440 | NPI | - | NPPES |
| 0020303 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Secondary |
| Provider Name | Phyllis C Hancock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285788034 PECOS PAC ID: 0749221232 Enrollment ID: I20150304001812 |
| Provider Name | Elizabeth R Burchard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336610591 PECOS PAC ID: 2163892670 Enrollment ID: I20221227002294 |
Children's Aid And Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 Pascack Rd, Park Ridge, NJ 07656 Phone: 201-664-7259 Fax: 201-762-1194 | |
Adl Therapy Nj Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Kinderkamack Rd, Park Ridge, NJ 07656 Phone: 845-548-3073 | |
Innovative Community Access Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 272 Prospect Ave, Park Ridge, NJ 07656 Phone: 201-486-9500 | |
Quest For Excellence International, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Broadway, Park Ridge, NJ 07656 Phone: 667-207-0445 | |
Children's Aid And Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 Pascack Rd, Park Ridge, NJ 07656 Phone: 201-664-7259 Fax: 201-664-7569 |