Provider Demographics
NPI:1376254706
Name:ENCANTO THERAPY GROUP LLC
Entity Type:Organization
Organization Name:ENCANTO THERAPY GROUP LLC
Other - Org Name:RESOLVE THERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR MENTAL HEALTH COUNSELING
Authorized Official - Prefix:
Authorized Official - First Name:JUSSETY
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:MONTERREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-241-3868
Mailing Address - Street 1:290 CHESTNUT ST UNIT 409
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-7013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1199 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2807
Practice Address - Country:US
Practice Address - Phone:201-252-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health