| Susan Menahem Psychotherapy Service, Pa | |
|
1119 Raritan Ave Highland Park NJ 08904-3639 | |
| (732) 246-8439 | |
| Not Available |
| Full Name | Susan Menahem Psychotherapy Service, Pa |
|---|---|
| Speciality | Social Worker |
| Location | 1119 Raritan Ave, Highland Park, New Jersey |
| Authorized Official Name and Position | Cory Nichols (BUSINESS DIRECTOR) |
| Authorized Official Contact | 7322468439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Menahem Psychotherapy Service, Pa 1119 Raritan Ave Highland Park NJ 08904-3639 Ph: (732) 246-8439 | Susan Menahem Psychotherapy Service, Pa 1119 Raritan Ave Highland Park NJ 08904-3639 Ph: (732) 246-8439 |
| NPI Number | 1366934374 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 06/05/2018 |
| Medicare PECOS PAC ID | 1557803889 |
|---|---|
| Medicare Enrollment ID | O20240603000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366934374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05260700 (New Jersey) | Primary |
| Provider Name | Virginia M Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609952290 PECOS PAC ID: 8123018082 Enrollment ID: I20040513001162 |
| Provider Name | Sheril Lynn Cantrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093839409 PECOS PAC ID: 6901347129 Enrollment ID: I20240916001038 |
| Provider Name | Lori Robin Sequeira |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295957942 PECOS PAC ID: 4385175306 Enrollment ID: I20241002000008 |
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