Healthcare Provider Details

I. General information

NPI: 1073676888
Provider Name (Legal Business Name): UNION COUNTY PSYCHOLOGICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SAINT PAUL ST
WESTFIELD NJ
07090-2145
US

IV. Provider business mailing address

124 SAINT PAUL ST
WESTFIELD NJ
07090-2145
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-8381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number01250
License Number StateNJ

VIII. Authorized Official

Name: LAWRENCE SASSO
Title or Position: PSYCHOLOGIST
Credential: ED.D.
Phone: 908-232-8381