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NPI Code Detail

MEDICARE: THE COUCH PSYCHOTHERAPY

MEDICARE: THE COUCH PSYCHOTHERAPY
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1245165950
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE COUCH PSYCHOTHERAPY
Provider Business Mailing Address
First Line : 79 MONTE VISTA AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-2429
Country : US
Telephone Number : 917-623-9673
Fax Number :
Provider Business Practice Location Address
First Line : 181 SOUTH ST
Second Line :
City : FREEHOLD
State : NJ
Zip : 07728-2164
Country : US
Telephone Number : 917-623-9673
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : JAMES HICKEY
Credential : LCSW
Telephone Number : 917-623-9673
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “THE COUCH PSYCHOTHERAPY ” Practice Location

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