Avance Therapeutic Leadership and Consultation Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

AVANCE THERAPEUTIC LEADERSHIP AND CONSULTATION SERVICES LLC

Doing business as

Mental health Services

Practice address

861 Robinwood Rd
Township of Washington, NJ 07676-4244

Phone

(201) 303-6704

NPI assigned

Dec 6, 2022

Organization subpart

No

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

Authorized official

Name

Hayden Moore, LCSWNPI 1669079869

Title

Owner

Phone

(201) 303-6704

Specialties & licenses 1

Addresses

Other names 1

• Mental health Services Doing business as

Practitioners 1

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

• Hayden N Moore, 44SC04689500

  • Clinical Social Worker
  • Township of Washington, NJ
  • NPI 1669079869
  NPD Authorized official

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1902517485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 ROBINWOOD RD",
            "city": "TOWNSHIP OF WASHINGTON",
            "state": "NJ",
            "postal_code": "076764244",
            "telephone_number": "201-303-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 ROBINWOOD RD",
            "city": "TOWNSHIP OF WASHINGTON",
            "state": "NJ",
            "postal_code": "076764244",
            "telephone_number": "201-303-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANCE THERAPEUTIC LEADERSHIP AND CONSULTATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-303-6704",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aah of Bergen County Inc
• Tyler Matthew Ardizzone, DPT
• Frank Chester Armstrong, A.T.,C
• Avicenna Pain Treatment Group
• Bergen County Yjcc
• Bergen Geri-Psych Institute PC
• Paula Michelle Bondoc
• Jessica Brody, M.S. CCC-SLP

• Clinical Social Worker in Township of Washington, NJ
• Providers in Township of Washington, 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 Dec 6, 2022; 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.