NPIMap

Organization Active NPI

Bergen Psychiatric Associates

  • Clinical Social Worker
  • Hackensack, NJ
National Provider Identifier
1588944979
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05276600 Issued in NJ
Legal business name
BERGEN PSYCHIATRIC ASSOCIATES
Practice address
294 State St
Suite# 2
Hackensack, NJ 07601-5515
Phone
(201) 833-5791
Fax
(201) 243-7874
NPI assigned
Aug 17, 2011
Last updated
Aug 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Authorized official

Name
Mr. Mohsan Jan
Title
Administartor
Phone
(201) 833-5791

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00351700 NJ
Clinical Social Worker 1041C0700X 44SC05276600 NJ Primary

Addresses

Primary practice location

294 State St
Suite# 2
Hackensack, NJ 07601-5515

Mailing address

PO Box 809
Teaneck, NJ 07666-0809
Phone (201) 833-5791

National Provider Directory

National Provider Directory
Tax ID family
Bergen Psychiatric Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1588944979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076660809",
            "telephone_number": "201-833-5791",
            "fax_number": "201-243-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 STATE ST",
            "address_2": "SUITE# 2",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015515",
            "telephone_number": "201-833-5791",
            "fax_number": "201-243-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "JAN",
        "authorized_official_first_name": "MOHSAN",
        "authorized_official_title_or_position": "ADMINISTARTOR",
        "authorized_official_telephone_number": "201-833-5791",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00351700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05276600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.