MEDICARE: BUG AND BEAR DESIGNS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1013530708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUG AND BEAR DESIGNS LLC

Provider Business Mailing Address
First Line	:	102 N MOUNTAIN AVE
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2350
Country	:	US
Telephone Number	:	561-542-0273
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 BLOOMFIELD AVE STE 2
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-3416
Country	:	US
Telephone Number	:	561-542-0273
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TRACEY KIRSCHNER KAYNE
Credential	:
Telephone Number	:	561-542-0273

Provider Enumeration Date	:	05/28/2020
Last Update Date	:	05/28/2020

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