Provider Demographics
NPI:1164935730
Name:DBT AND TRAUMA RECOVERY LLC
Entity Type:Organization
Organization Name:DBT AND TRAUMA RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-743-8277
Mailing Address - Street 1:3176 STATE ROUTE 27 STE 2B
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1514
Mailing Address - Country:US
Mailing Address - Phone:732-743-8277
Mailing Address - Fax:732-719-5650
Practice Address - Street 1:3176 STATE ROUTE 27 STE 2B
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1514
Practice Address - Country:US
Practice Address - Phone:732-743-8277
Practice Address - Fax:732-719-5650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054586001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty