| Elements Psychological Services, Llc | |
|
210 Summit Ave Ste C-2a Montvale NJ 07645-1579 | |
| (201) 383-5056 | |
| Not Available |
| Full Name | Elements Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 210 Summit Ave Ste C-2a, Montvale, New Jersey |
| Authorized Official Name and Position | Jessica Amelia Mccarthy (DIRECTOR) |
| Authorized Official Contact | 2013835056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elements Psychological Services, Llc 210 Summit Ave Ste C-2a Montvale NJ 07645-1579 Ph: (201) 383-5056 | Elements Psychological Services, Llc 210 Summit Ave Ste C-2a Montvale NJ 07645-1579 Ph: (201) 383-5056 |
| NPI Number | 1447873781 |
|---|---|
| Provider Enumeration Date | 05/21/2020 |
| Last Update Date | 03/18/2021 |
| Certification Date | 03/18/2021 |
| Medicare PECOS PAC ID | 0244653442 |
|---|---|
| Medicare Enrollment ID | O20200707001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447873781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica J Degaetano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205355542 PECOS PAC ID: 6901163278 Enrollment ID: I20171122001923 |
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