Provider Demographics
NPI:1013307370
Name:ALLIED MENTAL HEALTH SERVICES PC
Entity Type:Organization
Organization Name:ALLIED MENTAL HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC,LPC
Authorized Official - Phone:917-364-3785
Mailing Address - Street 1:40 CLINTON ST
Mailing Address - Street 2:200393
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3727
Mailing Address - Country:US
Mailing Address - Phone:917-364-3785
Mailing Address - Fax:
Practice Address - Street 1:40 CLINTON ST
Practice Address - Street 2:200393
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3727
Practice Address - Country:US
Practice Address - Phone:917-364-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00510200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty