Organization
ALCHEMICAL KINNECTIONS INTEGRATIVE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURRAINE BASCOME LCSW (FOUNDER / CEO)
(929) 352-2098
Entity
Organization
Contact information
Practice address
109 FRANK E RODGERS BLVD S, HARRISON, NJ 07029-2085
(929) 352-2098
Mailing address
111 TOWN SQUARE PL STE 1238, JERSEY CITY, NJ 07310-1810
(929) 352-2098
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
05/19/2025
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