Healthcare Provider Details

I. General information

NPI: 1821392473
Provider Name (Legal Business Name): HUDSON RIVER CARE AND COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 GRAND AVE THIRD FLOOR
ENGLEWOOD NJ
07631-3572
US

IV. Provider business mailing address

114 BROOKVIEW TER
BERGENFIELD NJ
07621-3100
US

V. Phone/Fax

Practice location:
  • Phone: 201-962-6443
  • Fax: 201-541-8100
Mailing address:
  • Phone: 201-962-6443
  • Fax: 201-541-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA J. PATER-ENNIS
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LCSW
Phone: 201-541-8100