Provider Demographics
NPI:1740699230
Name:THE CENTER FOR INTEGRATIVE PSYCHIATRY & COUNSELING
Entity type:Organization
Organization Name:THE CENTER FOR INTEGRATIVE PSYCHIATRY & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-487-4298
Mailing Address - Street 1:1 UNIVERSITY PLZ
Mailing Address - Street 2:SUITE 618
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6201
Mailing Address - Country:US
Mailing Address - Phone:201-487-4298
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PLZ
Practice Address - Street 2:SUITE 618
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6201
Practice Address - Country:US
Practice Address - Phone:201-487-4298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC0792106H00000X
NJMA0659482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty