Healthcare Provider Details

I. General information

NPI: 1215285291
Provider Name (Legal Business Name): COMPREHENSIVE BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2012
Last Update Date: 08/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 VALLEY BROOK AVE
LYNDHURST NJ
07071-1930
US

IV. Provider business mailing address

516 VALLEY BROOK AVE
LYNDHURST NJ
07071-1930
US

V. Phone/Fax

Practice location:
  • Phone: 201-935-3322
  • Fax: 201-935-3991
Mailing address:
  • Phone: 201-935-3322
  • Fax: 201-935-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MISS DANA J JAWORSKI
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 201-935-3322