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General NPI Number Information
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NPI Number | 1467776492
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Entity Type | Organization
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Legal Business Name | JOHN STEPHEN LOCONTE PHD LLC
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 697 VALLEY ST SUITE 2A
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2641
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Country | US
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Telephone | 973-762-7162
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Fax | 973-762-7164
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Provider Business Mailing Address
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Address Line | 697 VALLEY ST SUITE 2A
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2641
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Country | US
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Telephone | 973-762-7162
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Fax | 973-762-7164
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JOHN S LOCONTE
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Credential | PH.D.
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Telephone | 973-762-7162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical
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License Number | 35S100359800
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License Number State | NJ
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