Provider Demographics
NPI:1720285570
Name:CENTER FOR HEALTH PSYCHOLOGY, PA
Entity Type:Organization
Organization Name:CENTER FOR HEALTH PSYCHOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRTLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-753-1800
Mailing Address - Street 1:2 ETHEL RD
Mailing Address - Street 2:SUITE 203C
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2839
Mailing Address - Country:US
Mailing Address - Phone:732-662-7458
Mailing Address - Fax:732-662-7460
Practice Address - Street 1:2 ETHEL RD
Practice Address - Street 2:SUITE 203C
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2839
Practice Address - Country:US
Practice Address - Phone:732-662-7458
Practice Address - Fax:732-662-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00168200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty