Provider Demographics
NPI:1255508842
Name:CLINICAL PSYCHOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CLINICAL PSYCHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ZAKRESKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-544-9079
Mailing Address - Street 1:40 AVE AT THE COMMON
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07704
Mailing Address - Country:US
Mailing Address - Phone:732-544-9079
Mailing Address - Fax:732-544-9079
Practice Address - Street 1:40 AVENUE AT THE CMN
Practice Address - Street 2:SUITE 203
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4800
Practice Address - Country:US
Practice Address - Phone:732-544-9079
Practice Address - Fax:732-544-9079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1922103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty