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General NPI Number Information
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NPI Number | 1972452126
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Entity Type | Organization
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Legal Business Name | ENGLEWOOD PSYCHOTHERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 163 ENGLE ST STE 2
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2530
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Country | US
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Telephone | 551-361-0126
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Fax |
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Provider Business Mailing Address
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Address Line | 163 ENGLE ST STE 2
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2530
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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 | OWNER
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Name | ELISSA GROSS
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Credential |
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Telephone | 407-476-5615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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