Provider Demographics
NPI:1750338661
Name:TELA, JAMES (LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:TELA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4-16 SKYTOP GARDENS
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-2104
Mailing Address - Country:US
Mailing Address - Phone:908-420-3103
Mailing Address - Fax:732-727-9425
Practice Address - Street 1:1100 MADISON AVE. - SUITE 7L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0327
Practice Address - Country:US
Practice Address - Phone:212-252-3133
Practice Address - Fax:732-727-9425
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0700831041C0700X
NJ070083-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical