Healthcare Provider Details
I. General information
NPI: 1811547276
Provider Name (Legal Business Name): HILLER PSYCHOTHERAPY AND COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2019
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1029 TEANECK RD
TEANECK NJ
07666-4514
US
IV. Provider business mailing address
1029 TEANECK RD
TEANECK NJ
07666-4514
US
V. Phone/Fax
- Phone: 917-841-5343
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
SARAH
HILLER
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 917-841-5343