Provider Demographics
NPI:1942753066
Name:NORTH JERSEY PSYCHODYNAMICS LLC
Entity Type:Organization
Organization Name:NORTH JERSEY PSYCHODYNAMICS LLC
Other - Org Name:LANCE STERN LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-447-6443
Mailing Address - Street 1:39 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-3328
Mailing Address - Country:US
Mailing Address - Phone:201-447-6443
Mailing Address - Fax:
Practice Address - Street 1:39 HOWARD ST
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-3328
Practice Address - Country:US
Practice Address - Phone:201-447-6443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05678100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health