Healthcare Provider Details

I. General information

NPI: 1932011897
Provider Name (Legal Business Name): ELIM PSYCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SYLVAN AVE STE 208
ENGLEWOOD CLIFFS NJ
07632-3122
US

IV. Provider business mailing address

550 SYLVAN AVE STE 208
ENGLEWOOD CLIFFS NJ
07632-3122
US

V. Phone/Fax

Practice location:
  • Phone: 551-202-9120
  • Fax: 201-734-6190
Mailing address:
  • Phone: 551-202-9120
  • Fax: 201-734-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: IN JIN LEE
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 551-202-9120