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Organization

WINTERTREE PSYCHOTHERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN LEE BENENSON MSW, LCSW (OWNER)
(973) 650-1832
Entity
Organization

Contact information

Practice address
129 VALLEY RD, MONTCLAIR, NJ 07042-2331
(973) 650-1832
Mailing address
31 COBBLESTONE TER, MONTVILLE, NJ 07045-9490
(973) 650-1832

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
44SC
NJ
261QM0850X
Adult Mental Health Clinic/Center
Primary
44SC05749600
NJ
261QM0850X
Adult Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205365160
TYPE 1
NJ
Enumeration date
11/27/2017
Last updated
03/12/2018
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