Provider Demographics
NPI:1841612280
Name:WEST ESSEX PSYCHOLOGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WEST ESSEX PSYCHOLOGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARTKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-228-2299
Mailing Address - Street 1:104 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1324
Mailing Address - Country:US
Mailing Address - Phone:973-228-2299
Mailing Address - Fax:973-251-9461
Practice Address - Street 1:104 EAGLE ROCK AVE
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1324
Practice Address - Country:US
Practice Address - Phone:973-228-2299
Practice Address - Fax:973-251-9461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-18
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty