| Organization Name: | BERGEN PSYCHOLOGICAL SERVICES, LLC |
| NPI Number: | 1083040232 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YESENIA FLORES (OWNER) |
| Mailing Address: | 1605 John St Ste 208 Fort Lee |
| State: | NJ US |
| Postal Code: | 070242550 |
| Phone Number: | 9734327230 |
| Fax Number: | 2017944499 |
| NPI Enumeration Date: | 09/19/2013 |
| NPI Last Update Date: | 10/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35SI00492800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |