Provider Demographics
NPI:1447780226
Name:PSYCHOLOGICAL COUNSELING AND EMPOWERMENT
Entity Type:Organization
Organization Name:PSYCHOLOGICAL COUNSELING AND EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARDONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-612-7100
Mailing Address - Street 1:60 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1932
Mailing Address - Country:US
Mailing Address - Phone:917-612-7100
Mailing Address - Fax:
Practice Address - Street 1:71 FRANKLIN TPKE STE 1-2
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1800
Practice Address - Country:US
Practice Address - Phone:917-612-7100
Practice Address - Fax:201-943-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057218001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty