Provider Demographics
NPI:1174646061
Name:COGNITIVE BEHAVIOR THERAPY INSTITUTE, LLC
Entity Type:Organization
Organization Name:COGNITIVE BEHAVIOR THERAPY INSTITUTE, LLC
Other - Org Name:CBT INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-490-3590
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-0099
Mailing Address - Country:US
Mailing Address - Phone:212-490-3590
Mailing Address - Fax:
Practice Address - Street 1:101 EISENHOWER PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1032
Practice Address - Country:US
Practice Address - Phone:212-490-3590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014277-1103TC0700X
NJ35SI00394200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2721370OtherOXFORD
NYP2721370OtherOXFORD