Provider Demographics
NPI:1548759715
Name:4MIND2BODY THERAPEUTIC INSTITUTE L.L.C.
Entity Type:Organization
Organization Name:4MIND2BODY THERAPEUTIC INSTITUTE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:MRS
Authorized Official - First Name:NARDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDENA
Authorized Official - Suffix:
Authorized Official - Credentials:MA/EDS-LMFT
Authorized Official - Phone:973-525-2314
Mailing Address - Street 1:5 BEEMAN PL
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1337
Mailing Address - Country:US
Mailing Address - Phone:973-525-2314
Mailing Address - Fax:973-786-4260
Practice Address - Street 1:5 BEEMAN PL
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1337
Practice Address - Country:US
Practice Address - Phone:973-525-2314
Practice Address - Fax:973-786-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00177300106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty