Provider Demographics
NPI:1629381264
Name:RIDGEWOOD INSTITUTE FOR INTEGRAL PSYCHOTHERAPY
Entity Type:Organization
Organization Name:RIDGEWOOD INSTITUTE FOR INTEGRAL PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:201-445-1068
Mailing Address - Street 1:20 WILSEY SQ
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3793
Mailing Address - Country:US
Mailing Address - Phone:201-445-1068
Mailing Address - Fax:201-445-7995
Practice Address - Street 1:20 WILSEY SQ
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3793
Practice Address - Country:US
Practice Address - Phone:201-445-1068
Practice Address - Fax:201-445-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-25
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05409600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health