Organization
LEGEND PSYCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BLAKE W JONAS LMFT (OWNER)
(201) 523-4113
Entity
Organization
Contact information
Practice address
550 KINDERKAMACK RD STE 108, ORADELL, NJ 07649-1500
(201) 523-4113
Mailing address
239 PROSPECT AVE APT 1, NEW MILFORD, NJ 07646-1764
(201) 523-4113
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/09/2021
Last updated
05/27/2021
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