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General NPI Number Information
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NPI Number | 1457780272
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Entity Type | Organization
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Legal Business Name | PRINCETON BEHAVIORAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 34 ORCHARD SQ
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City | CALDWELL
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State | NJ
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Zip | 07006-5122
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Country | US
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Telephone | 908-616-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 34 ORCHARD SQ
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City | CALDWELL
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State | NJ
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Zip | 07006-5122
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Country | US
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Telephone | 609-766-0426
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Fax | 609-474-3525
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MICHAEL ELLIOTT
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Credential |
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Telephone | 609-766-0426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC054993300
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License Number State | NJ
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