Provider Demographics
NPI:1609943711
Name:MT. CARMEL GUILD BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:MT. CARMEL GUILD BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-395-4800
Mailing Address - Street 1:5 GLEN LN
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2206
Mailing Address - Country:US
Mailing Address - Phone:201-391-6980
Mailing Address - Fax:
Practice Address - Street 1:285 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3906
Practice Address - Country:US
Practice Address - Phone:201-395-4800
Practice Address - Fax:201-435-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00341100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty