Provider Demographics
NPI:1912430166
Name:CENTER FOR ANXIETY AND BEHAVIOR MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CENTER FOR ANXIETY AND BEHAVIOR MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FARACI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-914-2624
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:SCHOOLEYS MOUNTAIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07870-0021
Mailing Address - Country:US
Mailing Address - Phone:908-914-2624
Mailing Address - Fax:
Practice Address - Street 1:1 MILL RIDGE LN
Practice Address - Street 2:SUITE 209
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2488
Practice Address - Country:US
Practice Address - Phone:908-914-2624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100521400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty