Provider Demographics
| NPI: | 1134176720 |
|---|---|
| Name: | COMPREHENSIVE BEHAVIORAL HEALTHCARE, INC. |
| Entity type: | Organization |
| Organization Name: | COMPREHENSIVE BEHAVIORAL HEALTHCARE, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | BILLING SUPERVISOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DANA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | JAWORSKI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 201-935-3322 |
| Mailing Address - Street 1: | 516 VALLEY BROOK AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LYNDHURST |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 07071-1930 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 201-935-3322 |
| Mailing Address - Fax: | 201-935-3991 |
| Practice Address - Street 1: | 516 VALLEY BROOK AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | LYNDHURST |
| Practice Address - State: | NJ |
| Practice Address - Zip Code: | 07071-1930 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 201-935-3322 |
| Practice Address - Fax: | 201-935-3991 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-05-28 |
| Last Update Date: | 2022-12-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
| No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NJ | 0084603 | Medicaid | |
| NJ | 4549805 | Medicaid | |
| NJ | 0036501 | Medicaid | |
| NJ | 8369101 | Medicaid | |
| NJ | 0006602 | Medicaid | |
| NJ | 0107191 | Medicaid | |
| NJ | 0019992 | Medicaid | |
| NJ | 0084603 | Medicaid |
