| Family Service League,inc. | |
|
204 Claremont Ave Montclair NJ 07042-3409 | |
| (973) 746-0800 | |
| (973) 746-2822 |
| Full Name | Family Service League,inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 Claremont Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Sarah B. Wolman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9737460800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service League,inc. 204 Claremont Ave Montclair NJ 07042-3409 Ph: (973) 746-0800 | Family Service League,inc. 204 Claremont Ave Montclair NJ 07042-3409 Ph: (973) 746-0800 |
| NPI Number | 1881855542 |
|---|---|
| Provider Enumeration Date | 06/24/2008 |
| Last Update Date | 06/24/2008 |
| Medicare PECOS PAC ID | 4981659034 |
|---|---|
| Medicare Enrollment ID | O20050322000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881855542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Paula C Ochs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790915122 PECOS PAC ID: 7719934041 Enrollment ID: I20050407000975 |
| Provider Name | Jasmine E Chambers |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669157871 PECOS PAC ID: 3072058254 Enrollment ID: I20240711003296 |
| Provider Name | Stephanie M Mathelier |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669935599 PECOS PAC ID: 1456897974 Enrollment ID: I20240721000032 |
| Provider Name | Marisol Chinchay |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639934961 PECOS PAC ID: 8628514148 Enrollment ID: I20240721000043 |
| Provider Name | Stephanie R Koeller |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437748639 PECOS PAC ID: 8820453194 Enrollment ID: I20240721000065 |
| Provider Name | Edward W Weikert |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285864678 PECOS PAC ID: 7012955495 Enrollment ID: I20240722000348 |
| Provider Name | Jessica Romain |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1326534983 PECOS PAC ID: 3476990979 Enrollment ID: I20240723000564 |
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