Healthcare Provider Details

I. General information

NPI: 1245165950
Provider Name (Legal Business Name): THE COUCH PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 SOUTH ST
FREEHOLD NJ
07728-2164
US

IV. Provider business mailing address

79 MONTE VISTA AVE
RIDGEWOOD NJ
07450-2429
US

V. Phone/Fax

Practice location:
  • Phone: 917-623-9673
  • Fax:
Mailing address:
  • Phone: 917-623-9673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMES HICKEY
Title or Position: PARTNER
Credential: LCSW
Phone: 917-623-9673