| Tri-county Behavioral Care, Llc | |
|
21 Us Highway 206 #2 Stanhope NJ 07874-3275 | |
| (973) 691-3030 | |
| Not Available |
| Full Name | Tri-county Behavioral Care, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 21 Us Highway 206, Stanhope, New Jersey |
| Authorized Official Name and Position | Kelly Clare Canzone (OWNER / CLINICAL DIRECTOR) |
| Authorized Official Contact | 9736913030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-county Behavioral Care, Llc 21 Us Highway 206 #2 Stanhope NJ 07874-3275 Ph: (973) 691-3030 | Tri-county Behavioral Care, Llc 21 Us Highway 206 #2 Stanhope NJ 07874-3275 Ph: (973) 691-3030 |
| NPI Number | 1497141154 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 06/24/2016 |
| Medicare PECOS PAC ID | 0143538942 |
|---|---|
| Medicare Enrollment ID | O20150928002467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497141154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05283700 (New Jersey) | Primary |
| Provider Name | Kelly Canzone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316992977 PECOS PAC ID: 1052629854 Enrollment ID: I20150928002597 |
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