Healthcare Provider Details

I. General information

NPI: 1114950367
Provider Name (Legal Business Name): S AND D PSYCHOTHERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 HOPPER AVE
WALDWICK NJ
07463-1517
US

IV. Provider business mailing address

PO BOX 322
WALDWICK NJ
07463-0322
US

V. Phone/Fax

Practice location:
  • Phone: 201-803-2517
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DALE F FINK
Title or Position: PARTNER
Credential: LCSW
Phone: 201-803-2517