Provider Demographics
NPI:1942566054
Name:BERGEN COUNTY CENTER FOR EDUCATIONAL & PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:BERGEN COUNTY CENTER FOR EDUCATIONAL & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUWENT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:201-664-2670
Mailing Address - Street 1:354 OLD HOOK RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3246
Mailing Address - Country:US
Mailing Address - Phone:201-664-2670
Mailing Address - Fax:
Practice Address - Street 1:354 OLD HOOK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3246
Practice Address - Country:US
Practice Address - Phone:201-664-2670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100373100103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1902944176OtherINDIVIDUAL NPI