Provider Demographics
NPI:1508082405
Name:STRIDES IN PSYCHOTHERAPY
Entity Type:Organization
Organization Name:STRIDES IN PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TAMM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-873-3100
Mailing Address - Street 1:15 CLYDE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-873-3100
Mailing Address - Fax:732-873-3100
Practice Address - Street 1:15 CLYDE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3425
Practice Address - Country:US
Practice Address - Phone:732-873-3100
Practice Address - Fax:732-873-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100392600103TC0700X
NJ35S100395000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083430Medicare ID - Type Unspecified