Provider Demographics
NPI:1598298978
Name:CENTER FOR PSYCHOLOGICAL ASSESSMENT AND TREATMENT
Entity Type:Organization
Organization Name:CENTER FOR PSYCHOLOGICAL ASSESSMENT AND TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:AMSELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-200-7791
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:PITTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08867-0541
Mailing Address - Country:US
Mailing Address - Phone:908-200-7791
Mailing Address - Fax:908-200-7790
Practice Address - Street 1:1200 US HIGHWAY 22
Practice Address - Street 2:SUITE 2000
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2943
Practice Address - Country:US
Practice Address - Phone:908-200-7791
Practice Address - Fax:908-200-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00374700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8042705Medicaid