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General NPI Number Information
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NPI Number | 1376254706
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Entity Type | Organization
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Legal Business Name | ENCANTO THERAPY GROUP LLC
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Dates
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Enumeration Date | 12/06/2022
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1199 US HIGHWAY 22
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2807
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Country | US
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Telephone | 201-252-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 290 CHESTNUT ST UNIT 409
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City | ROSELLE PARK
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State | NJ
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Zip | 07204-7013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR MENTAL HEALTH COUNSELING
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Name | JUSSETY VANESSA MONTERREY
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Credential |
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Telephone | 973-241-3868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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