PASCACK MENTAL HEALTH CENTER (NPI# 1154526440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154526440 |
| Entity Type | Organization |
| Organization Name | PASCACK MENTAL HEALTH CENTER |
| Practice Address |
114 Kinderkamack Road Park Ridge NJ 07656-2126 |
| Mailing Address |
Po Box 126 114 Kinderkamack Road Park Ridge NJ 07656-2126 |
| Practice Telephone | 2013911355 |
| Practice Fax Number | 2013919516 |
| Mailing Telephone | 2013911355 |
| Mailing Fax Number | 2013919516 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2007-10-16 |
| Authorized Official Name | MR. JORGE BECERRA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2013911355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0020303 | 05 |
| Street Address |
114 KINDERKAMACK ROAD |
| City | PARK RIDGE |
| State | NJ |
| Zip Code | 07656-2126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972168326 | Cynthia J. Blake | Social Worker | Pascack Mental Health, 114 Kinderkamack Road, Park Ridge, NJ 07656 | 2019-05-01 |
| 1396251500 | Tocia Floris | Licensed Practical Nurse | 2 Lorraine Drive, Park Ridge, NJ 07656 | 2017-12-26 |
| 1528505625 | Sonal Desai | Registered Nurse | 2 Williams Crest, Park Ridge, NJ 07656 | 2017-01-26 |
| 1871960484 | Dr. Mark Schwartz, P.a. | Clinic/Center | 308 Chelsea Manor, Park Ridge, NJ 07656 | 2015-08-31 |
| 1871767194 | Arnold M. Sobel | Anesthesiology | 210 Bearwoods Road, Park Ridge, NJ 07656 | 2008-04-17 |
| 1548472145 | Deborah Renee Brodt Donnelly | Social Worker | 284 Spring Valley Rd, Park Ridge, NJ 07656 | 2007-05-04 |
| 1720204720 | Alan Zampieri | Pharmacist | 713 Butternut Dr, Franklin Lakes, NJ 07656 | 2007-04-18 |
| 1689790198 | Anthony M Riotto | Chiropractor | 128 Kinderkamack Road, Park Ridge, NJ 07656 | 2007-03-22 |
| 1063584605 | Christine M Ramagnano | Social Worker | 116 Warren Road, Park Ridge, NJ 07656 | 2006-11-15 |
| 1649647488 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 199 Kinderkamack Rd, Park Ridge, NJ 07656 | 2015-08-27 |
| Find all providers in zip 07656 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877523 | Duvia Correa | Counselor | 1137 N Lincoln Ave, Park Ridge, IL 60068-2026 | 2020-10-05 |
| 1285179820 | Brandon Tessers | Counselor | 1440 Renaissance Dr Ste 440, Park Ridge, IL 60068-1414 | 2017-01-05 |
| 1740674266 | Christin Coffey | Counselor | 211 S Hamlin Ave, Park Ridge, IL 60068-3836 | 2015-03-23 |
| 1356782759 | David E Briggs | Counselor | 151 Yost Ave, Park Ridge, IL 60068-5549 | 2013-07-13 |
| 1043528540 | Rachel Wonjung Yoon | Counselor | 1875 Dempster St Ste 330, Park Ridge, IL 60068-1186 | 2010-09-17 |
| 1053595256 | David M. Marks | Counselor | 1550 N Northwest Hwy Ste 108f, Park Ridge, IL 60068-1458 | 2007-12-24 |
| 1144431396 | Christian J. Otto | Counselor | 9 S Fairview Ave, Suite 203, Park Ridge, IL 60068-4033 | 2007-05-26 |
| 1992913370 | Thomas Burton Willingham | Counselor | 131 Pascack Rd, Park Ridge, NJ 07656-1124 | 2007-05-18 |
| 1588711790 | Janis L Edwards | Counselor | 408 Elmore St, Park Ridge, IL 60068-3437 | 2007-01-03 |
| 1669444501 | Linda S. Levi | Counselor | 1580 N Northwest Hwy, Suite 111a, Park Ridge, IL 60068-1444 | 2006-02-05 |
| Find all providers in PARK RIDGE | ||||
| City | PARK RIDGE |
| Zip Code | 07656 |
Please comment or provide details below to improve the information on PASCACK MENTAL HEALTH CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.