Advanced Institute for Mind and Emotions Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ADVANCED INSTITUTE FOR MIND AND EMOTIONS INC

Practice address

27 Canal St,
Highland Lakes, NJ 07422-1203

Phone

(201) 497-0289

Fax

(866) 850-6432

NPI assigned

Jun 8, 2021

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, LCSW

Title

President

Phone

(201) 497-0289

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1891362836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CANAL ST,",
            "city": "HIGHLAND LAKES",
            "state": "NJ",
            "postal_code": "074221203",
            "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": "27 CANAL ST,",
            "city": "HIGHLAND LAKES",
            "state": "NJ",
            "postal_code": "074221203",
            "telephone_number": "201-497-0289",
            "fax_number": "866-850-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INSTITUTE FOR MIND AND EMOTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Highland Lakes, NJ
• Providers in Highland Lakes, 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 Jun 8, 2021; 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.