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General NPI Number Information
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NPI Number | 1649433889
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSN OF ESSEX AND MORRIS
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 60 EVERGREEN PL
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City | EAST ORANGE
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State | NJ
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Zip | 07018
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Country | US
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Telephone | 973-676-9111
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Fax | 973-676-9008
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Provider Business Mailing Address
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Address Line | 33 S FULLERTON AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3358
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Country | US
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Telephone | 973-509-9777
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Fax | 973-509-9218
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT N DAVISON
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Credential | MA LPC
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Telephone | 973-509-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 302090405
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License Number State | NJ
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