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General NPI Number Information
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NPI Number | 1710370382
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Entity Type | Organization
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Legal Business Name | DBT SKILLS GROUP NJ, LLC
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 205 RIDGEDALE AVE
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1349
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Country | US
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Telephone | 973-535-3626
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Fax |
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Provider Business Mailing Address
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Address Line | 205 RIDGEDALE AVE
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1349
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Country | US
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Telephone | 973-535-3626
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | SUSAN SIMON-FLEISCHER
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Credential | LCSW
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Telephone | 973-535-3626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44SC01337900
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License Number State | NJ
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