| Story Of Life Therapy Llc | |
|
572 Cumberland Ave Teaneck NJ 07666-2651 | |
| (201) 578-7831 | |
| Not Available |
| Full Name | Story Of Life Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 572 Cumberland Ave, Teaneck, New Jersey |
| Authorized Official Name and Position | Dalia Lightman (PSYCHOLOGIST) |
| Authorized Official Contact | 2015787831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Story Of Life Therapy Llc 572 Cumberland Ave Teaneck NJ 07666-2651 Ph: (201) 578-7831 | Story Of Life Therapy Llc 572 Cumberland Ave Teaneck NJ 07666-2651 Ph: (201) 578-7831 |
| NPI Number | 1154787281 |
|---|---|
| Provider Enumeration Date | 01/05/2016 |
| Last Update Date | 02/07/2020 |
| Certification Date | 02/07/2020 |
| Medicare PECOS PAC ID | 3870875800 |
|---|---|
| Medicare Enrollment ID | O20170126001058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154787281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dalia M Lightman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548628373 PECOS PAC ID: 3577869320 Enrollment ID: I20160304001010 |
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