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General NPI Number Information
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NPI Number | 1669942777
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL & EDUCATIONAL CONSULTING
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Dates
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Enumeration Date | 12/01/2018
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Last Update Date | 12/01/2018
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Provider Practice Location Address
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Address Line | 513 W MOUNT PLEASANT AVE STE 212
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1721
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Country | US
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Telephone | 973-400-8371
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Fax | 973-200-2580
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Provider Business Mailing Address
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Address Line | 12 IRON FORGE RD
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City | PARSIPPANY
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State | NJ
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Zip | 07054-4308
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Country | US
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Telephone | 973-953-9123
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Fax | 973-200-2580
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Authorized Official
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Title or Position | CLINICAL & SCHOOL PSYCHOLOGIST
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Name | DR. ELIZABETH MATHEIS
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Credential | PH.D.
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Telephone | 973-953-9123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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