| Center At 353 | |
|
353 Nassau St Princeton NJ 08540-4623 | |
| (609) 924-0060 | |
| (609) 924-7436 |
| Full Name | Center At 353 |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 353 Nassau St, Princeton, New Jersey |
| Authorized Official Name and Position | Whitney Ross (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6099240060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center At 353 353 Nassau St Princeton NJ 08540-4623 Ph: (609) 924-0060 | Center At 353 353 Nassau St Princeton NJ 08540-4623 Ph: (609) 924-0060 |
| NPI Number | 1093871394 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 1456486208 |
|---|---|
| Medicare Enrollment ID | O20100413000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093871394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 100520104 (New Jersey) | Primary |
| Provider Name | Amanda M Stylianou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932424843 PECOS PAC ID: 6800078775 Enrollment ID: I20110314000833 |
| Provider Name | Nicole M. Maccarone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114088929 PECOS PAC ID: 3779757661 Enrollment ID: I20111110000214 |
| Provider Name | Glenda S Mendelsohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417098575 PECOS PAC ID: 0446534903 Enrollment ID: I20170228001647 |
| Provider Name | Romelle H Lysenko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417290420 PECOS PAC ID: 0547537128 Enrollment ID: I20170602000600 |
| Provider Name | Brianne A Meade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982218590 PECOS PAC ID: 2163898776 Enrollment ID: I20221024001508 |
| Provider Name | Peggy A Grauwiler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518668086 PECOS PAC ID: 1557707056 Enrollment ID: I20240306003617 |
| Provider Name | Robert Hake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609477231 PECOS PAC ID: 7517303662 Enrollment ID: I20240311003751 |
| Provider Name | Donna R Renner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275287625 PECOS PAC ID: 5395183248 Enrollment ID: I20240410003720 |
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