Provider Demographics
NPI:1376356840
Name:YELLOW TABLE THERAPY LLC
Entity type:Organization
Organization Name:YELLOW TABLE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERADSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:862-217-6201
Mailing Address - Street 1:5 BOWLING GREEN PKWY
Mailing Address - Street 2:SUITE 159
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849
Mailing Address - Country:US
Mailing Address - Phone:862-217-6201
Mailing Address - Fax:
Practice Address - Street 1:5 BOWLING GREEN PKWY
Practice Address - Street 2:SUITE 159
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849
Practice Address - Country:US
Practice Address - Phone:862-217-6201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty