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General NPI Number Information
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NPI Number | 1649719766
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Entity Type | Organization
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Legal Business Name | BIRCH TREE PSYCHOLOGY
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 498 NEWARK POMPTON TPKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1930
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Country | US
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Telephone | 973-839-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 498 NEWARK POMPTON TPKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1930
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Country | US
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Telephone | 973-839-3060
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/ DIRECTOR
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Name | DR. BRITTANY RYAN-BERZINS
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Credential | PH.D.
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Telephone | 973-839-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 497800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4961
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License Number State | NJ
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