Healthcare Provider Details
I. General information
NPI: 1033581004
Provider Name (Legal Business Name): CENTER FOR PSYCHOLOGICAL ASSESSMENT AND TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2015
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 STATE ROUTE 28 STE 101
BRIDGEWATER NJ
08807-1979
US
IV. Provider business mailing address
PO BOX 541
PITTSTOWN NJ
08867-0541
US
V. Phone/Fax
- Phone: 908-200-7791
- Fax: 908-200-7790
- Phone: 908-200-7791
- Fax: 908-200-7790
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | NJ 5728 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LOREN
B
AMSELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PH.D.
Phone: 908-797-2026