Provider Demographics
NPI:1134210222
Name:THE STRESS CENTER FOR COMPREHENSIVE PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:THE STRESS CENTER FOR COMPREHENSIVE PSYCHOLOGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CANDELETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-693-7903
Mailing Address - Street 1:535 LACEY RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1533
Mailing Address - Country:US
Mailing Address - Phone:609-693-7903
Mailing Address - Fax:
Practice Address - Street 1:535 LACEY RD
Practice Address - Street 2:SUITE 6
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1533
Practice Address - Country:US
Practice Address - Phone:609-693-7903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00202900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty