Organization Name: | METRO NY DBT CENTER |
NPI Number: | 1063874774 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARRIE DIAMOND (SUPERVISING PSYCHOLOGIST) |
Mailing Address: | 205 Ridgedale Ave Suite 101 Florham Park |
State: | NJ US |
Postal Code: | 079321349 |
Phone Number: | 2125602437 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2016 |
NPI Last Update Date: | 03/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | NJ44SC05613800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |