Organization
BLUE BALLOON LCSW PLLC
Active
Organization
BLUE BALLOON LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOVID SUSSMAN (MEMBER)
(201) 216-9500
Entity
Organization
Contact information
Practice address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(201) 216-9500
Mailing address
175 BELGROVE DR, KEARNY, NJ 07032-1507
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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