Healthcare Provider Details
I. General information
NPI: 1508639469
Provider Name (Legal Business Name): SK THERAPY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2023
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1285 BROAD ST
BLOOMFIELD NJ
07003-3045
US
IV. Provider business mailing address
16 HAINES DR
BLOOMFIELD NJ
07003-2906
US
V. Phone/Fax
- Phone: 732-272-2855
- Fax:
- Phone: 732-272-2855
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SWETA
KANSAGRA
Title or Position: OWNER/CEO
Credential: LCSW
Phone: 732-272-2855