| Trauma-informed Psychotherapy, Llc | |
|
101 Park St # 3 Montclair NJ 07042-2963 | |
| (973) 447-4460 | |
| Not Available |
| Full Name | Trauma-informed Psychotherapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 101 Park St # 3, Montclair, New Jersey |
| Authorized Official Name and Position | Mark William Richardson (OWNER) |
| Authorized Official Contact | 2013778710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma-informed Psychotherapy, Llc 45 Bayliss St # 2 North Arlington NJ 07031-5548 Ph: (201) 377-8710 | Trauma-informed Psychotherapy, Llc 101 Park St # 3 Montclair NJ 07042-2963 Ph: (973) 447-4460 |
| NPI Number | 1902396104 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 7113272790 |
|---|---|
| Medicare Enrollment ID | O20180622000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902396104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05682000 (New Jersey) | Primary |
| Provider Name | Mark William Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699213785 PECOS PAC ID: 9931454519 Enrollment ID: I20180622001342 |
Ascending Wellness And Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Park St Ste 104, Montclair, NJ 07042 Phone: 973-932-0433 Fax: 484-634-2903 | |
Leigh Ann S. Tedesco, Lcsw Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 88 Park St, Montclair, NJ 07042 Phone: 973-857-6157 | |
Bug And Bear Designs Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 516 Bloomfield Ave Ste 2, Montclair, NJ 07042 Phone: 561-542-0273 | |
Mind & Body Healing Therapy Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18-20 Lackawanna Plz Ste 200, Montclair, NJ 07042 Phone: 973-988-1496 | |
Emergent Change Counseling & Healing Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18-20 Lackawanna Plz Ste 300, Montclair, NJ 07042 Phone: 973-671-4309 Fax: 973-629-1778 | |
Innovative Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Park St, Montclair, NJ 07042 Phone: 973-744-4300 | |
Psychotherapy Associates Of Montclair Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 182 Inwood Ave, Montclair, NJ 07043 Phone: 973-746-5650 Fax: 973-746-5556 |