MH AT FAIR LAWN LLC (NPI# 1073908018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073908018 |
| Entity Type | Organization |
| Organization Name | MH AT FAIR LAWN LLC |
| Practice Address |
16-01 Broadway Fair Lawn NJ 07410-2026 |
| Mailing Address |
2328 10th Ave N 3rd Floor Lake Worth FL 33461-6606 |
| Practice Telephone | 2017970001 |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2015-04-06 |
| Authorized Official Name | JAMES STOKES (CEO) |
| Authorized Official Telephone | 5613184455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
16-01 BROADWAY |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407276975 | Counseling Center At Fair Lawn, LLC | Clinic/Center | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2014-04-23 |
| 1760039564 | Jordan Brown Sander | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-26 |
| 1770130007 | Phoebe Elizabeth Sumas | Counselor | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-21 |
| 1982251401 | Kristie Ashe | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-20 |
| 1891340972 | Maria Medina | Social Worker | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-06 |
| 1609421908 | Adam Daniel | Counselor | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2019-08-05 |
| 1811372790 | Fair Lawn Diagnostics LLC | Clinical Medical Laboratory | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2015-07-21 |
| 1295131134 | Route 4 Medical Associates LLC | Clinical Medical Laboratory | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2014-11-04 |
| 1831595776 | 01 Medical Group LLC | Psychiatry & Neurology | 16-01 Broadway, Fair Lawn, NJ 07410-2026 | 2014-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093316 | Sheila Robinson-kiss LLC | Counselor | 0-178 Tunbridge Road, Fair Lawn, NJ 07410 | 2020-05-05 |
| 1750902813 | Pine Group LLC | Point of Service | 0-39 Pine Ave, Fair Lawn, NJ 07410 | 2020-04-29 |
| 1073133153 | Maria Jidriska Myers | Nurse Practitioner | 23-00 Nj-208, Fair Lawn, NJ 07410 | 2020-04-20 |
| 1508350869 | Jill Marie Deperi | Counselor | 22-08 Route 208 South, Fair Lawn, NJ 07410 | 2018-06-20 |
| 1952895419 | Laurel Olson | Counselor | Care Plus Nj Children and Family Services, 17-07 Romaine Street, Fair Lawn, NJ 07410 | 2018-06-19 |
| 1851896583 | Janelle Frazier | Social Worker | Care Plus New Jersey, 17-07 Romaine St, Fair Lawn, NJ 07410 | 2018-03-26 |
| 1457876260 | Daniella Suric | Behavioral Analyst | 2-08 Morlot Avenue, Fair Lawn, NJ 07410 | 2017-08-14 |
| 1912453549 | Marcia Gurfield | Social Worker | 33-03 Ryan Road, Fair Lawn, NJ 07410 | 2016-09-01 |
| 1417330721 | The Arc of Bergen and Passaic Counties, Inc | Day Training, Developmentally Disabled Services | 17-03a Broadway, Fair Lawn, NJ 07410 | 2015-07-06 |
| 1275914228 | Julius Iratagotia | Occupational Therapist | 0-53 26th St, Fair Lawn, NJ 07410 | 2015-06-16 |
| Find all providers in zip 07410 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841770526 | Mark E. Louie | Counselor | 33-07 Ryan Rd, Fair Lawn, NJ 07410-4607 | 2018-08-21 |
| 1952895419 | Laurel Olson | Counselor | Care Plus Nj Children and Family Services, 17-07 Romaine Street, Fair Lawn, NJ 07410 | 2018-06-19 |
| 1649654039 | Marina Goldenberg | Counselor | 14-11 Well Dr, Fair Lawn, NJ 07410-4403 | 2015-07-15 |
| 1720372469 | Metropolitan Mental Health PC | Counselor | 3-07 Linden Ln, Fair Lawn, NJ 07410-4826 | 2011-05-29 |
| 1346557709 | Jacqueline Patricia Winnicki | Counselor | 17-85 Chandler Dr, Fair Lawn, NJ 07410-2711 | 2010-09-07 |
| 1184803447 | Laurie Sigalos | Counselor | 33-11 Broadway Ste 201, The Chrysalis Group, LLC, Fair Lawn, NJ 07410-4638 | 2007-11-02 |
| 1659595601 | Lisa Steiner | Counselor | 22-08 State Rt 208, Suite 16, Fair Lawn, NJ 07410-2609 | 2007-04-12 |
| 1861554388 | Nancy Carol Fish | Counselor | 4-61 Ivy Ln, Fair Lawn, NJ 07410-1652 | 2006-12-14 |
| 1760552723 | Metropolitan Mental Health P C | Counselor | 33-11 Broadway Ave., Suite 203, Fair Lawn, NJ 07410 | 2006-11-08 |
| 1811934995 | Marilyn Sandra Pettinati | Counselor | 38-14 Morlot Ave, Fair Lawn, NJ 07410-4917 | 2006-05-31 |
| Find all providers in FAIR LAWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.