Provider Demographics
NPI:1417240045
Name:ONE-SELF HEALTH AND WELLNESS, INC.
Entity Type:Organization
Organization Name:ONE-SELF HEALTH AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-619-3963
Mailing Address - Street 1:209 COOPER AVE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1883
Mailing Address - Country:US
Mailing Address - Phone:973-619-3963
Mailing Address - Fax:
Practice Address - Street 1:209 COOPER AVE
Practice Address - Street 2:STE 5B
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1883
Practice Address - Country:US
Practice Address - Phone:973-619-3963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052774001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty