Provider Demographics
NPI:1417378720
Name:BEHAVIORAL HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJACIC-POPPE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-833-4100
Mailing Address - Street 1:757 TEANECK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4241
Mailing Address - Country:US
Mailing Address - Phone:201-833-4100
Mailing Address - Fax:201-837-1926
Practice Address - Street 1:757 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4241
Practice Address - Country:US
Practice Address - Phone:201-833-4100
Practice Address - Fax:201-837-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4992103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1598039083OtherINDIVIDUAL NPI