| NPI | 1023101748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH CHARLES BENCIVENNE Owner 973-771-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 35S100392200) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100392200) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35S100392200) | |
| 103TF0000X Psychologist, Family (Licence: NJ 35S100392200) | |
| 103TF0200X Psychologist, Forensic (Licence: NJ 35S100392200) | |
| 103TH0100X Psychologist, Health Service (Licence: NJ 35S100392200) | |
| 106H00000X Marriage & Family Therapist (Licence: NJ 37F100140300) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |