Provider Demographics
NPI:1114570942
Name:MARGO RAPPAPORT INSTITUTE FOR FUNCTIONAL PSYCHOTHERAPY
Entity Type:Organization
Organization Name:MARGO RAPPAPORT INSTITUTE FOR FUNCTIONAL PSYCHOTHERAPY
Other - Org Name:CENTER FOR FUNCTIONAL PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAPPAPORT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-590-5240
Mailing Address - Street 1:193 ROUTE 9 STE 2D
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3016
Mailing Address - Country:US
Mailing Address - Phone:732-590-5240
Mailing Address - Fax:
Practice Address - Street 1:193 ROUTE 9 STE 2D
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3016
Practice Address - Country:US
Practice Address - Phone:732-590-5240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-21
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty