Full Heart Recovery, LLC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

03509 Issued in NJ

Legal business name

FULL HEART RECOVERY, LLC

Practice address

543 Valley Rd
Suite 6
Upper Montclair, NJ 07043-1881

Phone

(973) 744-9130

Fax

(973) 863-2354

NPI assigned

Jan 31, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Henry Srednicki, PH.D.NPI 1255445326

Title

Member

Phone

(973) 744-9130

Specialties & licenses 1

Addresses

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

• Henry Srednicki, PHD

  • Psychologist
  • Upper Montclair, NJ
  • NPI 1255445326
  NPD (past) Authorized official
• Mario Dartayet-Rodriguez, LCSW, CSAT

  • Clinical Social Worker
  • Montclair, NJ
  • NPI 1487053278
  NPD (past)
• Janice Ellen Delorenzo, LCSW

  • Clinical Social Worker
  • Upper Montclair, NJ
  • NPI 1194800508
  NPD (past)
• Ofelia Rodriguez Srednicki, PHD

  • Clinical Psychologist
  • Upper Montclair, NJ
  • NPI 1184712044
  NPD (past)

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

{
    "created_epoch": "1422662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422662400000",
    "number": "1912397704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 VALLEY RD",
            "address_2": "SUITE 6",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431881",
            "telephone_number": "973-744-9130",
            "fax_number": "973-863-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 VALLEY RD",
            "address_2": "SUITE 6",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431881",
            "telephone_number": "973-744-9130",
            "fax_number": "973-863-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL HEART RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-31",
        "last_updated": "2015-01-31",
        "status": "A",
        "authorized_official_last_name": "SREDNICKI",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "973-744-9130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "03509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fokas Vision Corporation -Sally Fokas
• Sharon Jill Freedman, PH.D.
• Dawn C Fried, MSW LCSW
• Mark J Friedman, PH.D.
• Linda Friedricks, L.C.S.W.
• Marlon Todd Gieser, PH.D.
• Sherri S Glassman, PH.D.
• Edward David Gold, DDS
• Lydia Zborowski Golub, PHD
• William Michael Gordon, PH.D.

• All providers in Upper Montclair, NJ
• Addiction (Substance Use Disorder) Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2015; 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.