Provider Demographics
NPI:1295940104
Name:HERBERT COUNSELING AND PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:HERBERT COUNSELING AND PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-482-0120
Mailing Address - Street 1:2175 HUDSON TERRACE
Mailing Address - Street 2:SUITE 9G RIVER VIEW TOWERS
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7710
Mailing Address - Country:US
Mailing Address - Phone:201-482-0120
Mailing Address - Fax:201-482-0120
Practice Address - Street 1:2175 HUDSON TERRACE
Practice Address - Street 2:SUITE 9G RIVER VIEW TOWERS
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7719
Practice Address - Country:US
Practice Address - Phone:201-836-1065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC01287800102L00000X, 1041C0700X
NY0263851041C0700X
NY025385102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty