Provider Demographics
NPI:1114285582
Name:CENTER FOR RECOVERY FROM COMPULSIVE BEHAVIOR
Entity Type:Organization
Organization Name:CENTER FOR RECOVERY FROM COMPULSIVE BEHAVIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICLA SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MERK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-857-3404
Mailing Address - Street 1:80 POMPTON AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2945
Mailing Address - Country:US
Mailing Address - Phone:973-857-3404
Mailing Address - Fax:
Practice Address - Street 1:80 POMPTON AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2945
Practice Address - Country:US
Practice Address - Phone:973-857-3404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00592900251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health