Provider Demographics
NPI:1013961531
Name:SENIOR PSYCHOLOGICAL CARE INC
Entity Type:Organization
Organization Name:SENIOR PSYCHOLOGICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:KINDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-507-6363
Mailing Address - Street 1:106 HAGERMAN CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1674
Mailing Address - Country:US
Mailing Address - Phone:908-507-6363
Mailing Address - Fax:
Practice Address - Street 1:106 HAGERMAN CT
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1674
Practice Address - Country:US
Practice Address - Phone:908-507-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100411600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088968Medicare ID - Type UnspecifiedPSYCHOLOGY GROUP