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Organization

INNOVATIVE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY KRUVANT (PRESIDENT)
(973) 744-4300
Entity
Organization

Contact information

Practice address
101 PARK ST, MONTCLAIR, NJ 07042-2963
(973) 744-4300
Mailing address
11 BLACKBERRY LN, NORTH CALDWELL, NJ 07006-4170
(973) 744-4300

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
03/23/2009
Last updated
03/23/2009
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