Healthcare Provider Details

I. General information

NPI: 1467116947
Provider Name (Legal Business Name): FAMILIES AND COMMUNITIES UNITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 LAFAYETTE AVE # 204A
HAWTHORNE NJ
07506-2439
US

IV. Provider business mailing address

42 EDWARD CT.
CLIFTON NJ
07011
US

V. Phone/Fax

Practice location:
  • Phone: 973-222-4375
  • Fax:
Mailing address:
  • Phone: 973-222-4375
  • Fax: 201-484-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ESTHER DENISE MEZA
Title or Position: EXECUTIVE DIRECTOR
Credential: JD,MSW,LCSW
Phone: 973-222-4375