Provider Demographics
NPI:1346378221
Name:MJCI INSTITUTE, INC.
Entity Type:Organization
Organization Name:MJCI INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHPTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-726-4809
Mailing Address - Street 1:190 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OGDENSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07439-1137
Mailing Address - Country:US
Mailing Address - Phone:973-726-4809
Mailing Address - Fax:
Practice Address - Street 1:190 MAIN ST
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07439-1137
Practice Address - Country:US
Practice Address - Phone:973-726-4809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00753700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty