| Positive State Psychological & Behavioral Services, Llc | |
|
140 S Broadway Ste 7 Pitman NJ 08071-2235 | |
| (844) 365-7676 | |
| Not Available |
| Full Name | Positive State Psychological & Behavioral Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 140 S Broadway Ste 7, Pitman, New Jersey |
| Authorized Official Name and Position | Michelle Petrongolo (PSYCHOLOGIST) |
| Authorized Official Contact | 8443657676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive State Psychological & Behavioral Services, Llc 140 S Broadway Ste 7 Pitman NJ 08071-2235 Ph: (844) 365-7676 | Positive State Psychological & Behavioral Services, Llc 140 S Broadway Ste 7 Pitman NJ 08071-2235 Ph: (844) 365-7676 |
| NPI Number | 1194447599 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 09/13/2022 |
| Certification Date | 09/13/2022 |
| Medicare PECOS PAC ID | 4385014117 |
|---|---|
| Medicare Enrollment ID | O20230111003030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194447599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Michelle Petrongolo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447500574 PECOS PAC ID: 4284004011 Enrollment ID: I20230111003133 |
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