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Organization
VICI PSYCHOLOGICAL CARE LLC
Active
Organization
VICI PSYCHOLOGICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE MARIE LACHERZA-DREW PSYD (OWNER/LICENSED PSYCHOLOGIST)
(201) 639-4046
Entity
Organization
Contact information
Practice address
518 CARDINAL CT, LEDGEWOOD, NJ 07852-2616
(201) 639-4046
Mailing address
518 CARDINAL CT, LEDGEWOOD, NJ 07852-2616
(201) 639-4046
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/10/2020
Last updated
09/10/2024
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