Provider Demographics
NPI:1932262680
Name:NEW HORIZONS PSYCHOTHERAPY OF NORTH JERSEY PC
Entity Type:Organization
Organization Name:NEW HORIZONS PSYCHOTHERAPY OF NORTH JERSEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:COLLASO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:215-750-0459
Mailing Address - Street 1:668 STONY HILL RD
Mailing Address - Street 2:SUITE 255
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4497
Mailing Address - Country:US
Mailing Address - Phone:215-750-0459
Mailing Address - Fax:215-750-0489
Practice Address - Street 1:340 E MAPLE AVE
Practice Address - Street 2:SUITE 204C
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2850
Practice Address - Country:US
Practice Address - Phone:215-750-0459
Practice Address - Fax:215-750-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0154721041C0700X
NJ44SC047346001041C0700X
NY044809-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1962491407OtherNATIONAL INDIVIDUAL PROVI
NJ007070Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION N