Provider Demographics
NPI:1457128480
Name:REDLOCUS PSYCHOTHERAPY
Entity Type:Organization
Organization Name:REDLOCUS PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:SHERAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-583-1433
Mailing Address - Street 1:75 OSBORNE PL
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2921
Mailing Address - Country:US
Mailing Address - Phone:973-583-1433
Mailing Address - Fax:
Practice Address - Street 1:75 OSBORNE PL
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2921
Practice Address - Country:US
Practice Address - Phone:973-583-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty