Organization Name: | ROSELAND PSYCHOTHERAPY ASSOCIATES LLC |
NPI Number: | 1295909679 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL OVERLAND (DIRECTOR) |
Mailing Address: | 204 Eagle Rock Ave Roseland |
State: | NJ US |
Postal Code: | 070681723 |
Phone Number: | 9732261505 |
Fax Number: | 9732261506 |
NPI Enumeration Date: | 04/16/2008 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | S103685 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |