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General NPI Number Information
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NPI Number | 1871169763
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Entity Type | Organization
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Legal Business Name | TRI-STATE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 675 MORRIS AVE STE 202
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1523
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Country | US
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Telephone | 973-218-1176
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Fax |
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Provider Business Mailing Address
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Address Line | 1597 RAMAPO WAY
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City | SCOTCH PLAINS
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State | NJ
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Zip | 07076-2315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | BONNIE ROBINSON CIMRING
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Credential | PSY.D.
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Telephone | 973-218-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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