Healthcare Provider Details

I. General information

NPI: 1083264717
Provider Name (Legal Business Name): EH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2019
Last Update Date: 09/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 RIDGEDALE AVE
FLORHAM PARK NJ
07932-1764
US

IV. Provider business mailing address

325 E MOUNT PLEASANT AVE
LIVINGSTON NJ
07039-1501
US

V. Phone/Fax

Practice location:
  • Phone: 973-868-6746
  • Fax:
Mailing address:
  • Phone: 973-868-6746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIN HEDINGER
Title or Position: LCSW
Credential: LCSW
Phone: 973-868-6747