1851530026 NPI number — ACHIEVEMENT THROUGH COUNSELING AND THERAPY

Table of content: (NPI 1851530026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851530026 NPI number — ACHIEVEMENT THROUGH COUNSELING AND THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACHIEVEMENT THROUGH COUNSELING AND THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FRANCES GURLAND, M.D.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851530026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
362 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WYCKOFF
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07481-1928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-891-3933
Provider Business Mailing Address Fax Number:
201-891-6767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
362 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYCKOFF
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07481-1928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-891-3933
Provider Business Practice Location Address Fax Number:
201-891-6767
Provider Enumeration Date:
02/12/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MONASERT
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
P
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
201-891-3933

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TP0016X , with the licence number: 25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0802X , with the licence number: 25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 25MA07179000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0805X , with the licence number: 25MA05862700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 587794 . This is a "MEDICARE ID - TYPE UNSPECIFIED" identifier . This identifiers is of the category "OTHER".