Provider Demographics
NPI:1518738756
Name:HEALING OUR PARTS GROUP PSYCHOTHERAPY PRACTICE LLC
Entity Type:Organization
Organization Name:HEALING OUR PARTS GROUP PSYCHOTHERAPY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COTAYO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-678-6287
Mailing Address - Street 1:777 CLIFFORD SALADIN ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-5670
Mailing Address - Country:US
Mailing Address - Phone:347-678-6287
Mailing Address - Fax:347-230-5340
Practice Address - Street 1:777 CLIFFORD SALADIN ST
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-5670
Practice Address - Country:US
Practice Address - Phone:347-678-6287
Practice Address - Fax:347-230-5340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty