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General NPI Number Information
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NPI Number | 1881038636
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Entity Type | Organization
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Legal Business Name | AFFINITY PSYCHOTHERAPY ASSOCIATES LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 43 MAPLE AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7508
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Country | US
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Telephone | 973-476-4443
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Fax | 862-244-4628
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Provider Business Mailing Address
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Address Line | 4 ROLLING RIDGE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4532
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Country | US
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Telephone | 973-476-4443
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Fax | 862-244-4628
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Authorized Official
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Title or Position | OWNER OF PSYCHOTHERAPY PRACTICE
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Name | MRS. JOAN E TOMACHEK-CERNY
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Credential | MSW, LCSW
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Telephone | 973-476-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05198600
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License Number State | NJ
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