Provider Demographics
NPI:1417157199
Name:MONTCLAIR COUNSELING CENTER
Entity Type:Organization
Organization Name:MONTCLAIR COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEK-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:073-783-6977
Mailing Address - Street 1:183 INWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1908
Mailing Address - Country:US
Mailing Address - Phone:973-783-6977
Mailing Address - Fax:973-783-6597
Practice Address - Street 1:183 INWOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1908
Practice Address - Country:US
Practice Address - Phone:973-783-6977
Practice Address - Fax:973-783-6597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health