Healthcare Provider Details

I. General information

NPI: 1568337301
Provider Name (Legal Business Name): MONTVILLE THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 HOOK MOUNTAIN RD STE 100
PINE BROOK NJ
07058-9462
US

IV. Provider business mailing address

18 HOOK MOUNTAIN RD STE 100
PINE BROOK NJ
07058-9462
US

V. Phone/Fax

Practice location:
  • Phone: 973-358-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: REEMA TAJDAR
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 973-358-2121