Psychological Consulting and Therapy Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05391100 Issued in NJ

Legal business name

PSYCHOLOGICAL CONSULTING AND THERAPY INC

Practice address

71 Franklin Tpke
Suite 1-2
Waldwick, NJ 07463-1851

Phone

(201) 497-0289

Fax

(866) 850-6432

NPI assigned

Jul 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Valery E Fradkov, LCSWNPI 1841427663

Title

President

Phone

(201) 497-0289

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valery Eugene Fradkov, LCSW

  • Clinical Social Worker
  • Fair Lawn, NJ
  • NPI 1841427663
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1114370657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 FRANKLIN TPKE",
            "address_2": "SUITE 1-2",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631851",
            "telephone_number": "201-497-0289",
            "fax_number": "866-850-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 FRANKLIN TPKE",
            "address_2": "SUITE 1-2",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631851",
            "telephone_number": "201-497-0289",
            "fax_number": "866-850-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL CONSULTING AND THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "FRADKOV",
        "authorized_official_first_name": "VALERY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-497-0289",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05391100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Waldwick, NJ
• Providers in Waldwick, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.