Provider Demographics
NPI:1235256439
Name:PATERSON COUNSELING CENTER,INC
Entity Type:Organization
Organization Name:PATERSON COUNSELING CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:OVSJANIKOVSKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-523-8316
Mailing Address - Street 1:319-321 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-1805
Mailing Address - Country:US
Mailing Address - Phone:973-523-8316
Mailing Address - Fax:973-523-2448
Practice Address - Street 1:319-321 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-1805
Practice Address - Country:US
Practice Address - Phone:973-523-8316
Practice Address - Fax:973-523-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10CC0057900261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0101206Medicaid