Healthcare Provider Details

I. General information

NPI: 1245391853
Provider Name (Legal Business Name): THE CENTER FOR BEHAVIORAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CEDAR LN SUITE A
TEANECK NJ
07666-4315
US

IV. Provider business mailing address

175 CEDAR LN SUITE A
TEANECK NJ
07666-4315
US

V. Phone/Fax

Practice location:
  • Phone: 201-092-9500
  • Fax: 201-692-0234
Mailing address:
  • Phone: 201-092-9500
  • Fax: 201-692-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number10139
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARTIN KLUGER
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 201-692-9500