Provider Demographics
NPI:1760076699
Name:PIVOTAL PSYCHOTHERAPY SERVICES, LCSW, P.C.
Entity Type:Organization
Organization Name:PIVOTAL PSYCHOTHERAPY SERVICES, LCSW, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:TRIVEDI
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LBA, BCBA
Authorized Official - Phone:917-683-3911
Mailing Address - Street 1:830 MORRIS TPKE FL 4
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2625
Mailing Address - Country:US
Mailing Address - Phone:917-683-3911
Mailing Address - Fax:
Practice Address - Street 1:830 MORRIS TPKE FL 4
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2625
Practice Address - Country:US
Practice Address - Phone:917-683-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty