Healthcare Provider Details

I. General information

NPI: 1780743120
Provider Name (Legal Business Name): VREELAND ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 VREELAND AVE
NUTLEY NJ
07110-1618
US

IV. Provider business mailing address

145 VREELAND AVE
NUTLEY NJ
07110-1618
US

V. Phone/Fax

Practice location:
  • Phone: 973-235-1212
  • Fax: 973-235-1527
Mailing address:
  • Phone: 973-235-1212
  • Fax: 973-235-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04318600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00076200
License Number StateNJ

VIII. Authorized Official

Name: MR. THOMAS J LONGO
Title or Position: OWNER/PARTNER
Credential: HEALTH OFFICER
Phone: 973-634-8227