| Power House Psychotherapy & Addiction, Llc | |
|
654 Mount Prospect Ave Ste 201 Newark NJ 07104-3110 | |
| (862) 888-8146 | |
| Not Available |
| Full Name | Power House Psychotherapy & Addiction, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 654 Mount Prospect Ave Ste 201, Newark, New Jersey |
| Authorized Official Name and Position | Temitope Shakirat Coates (EXECUTIVE DIRECTOR/ADMINISTRATOR) |
| Authorized Official Contact | 9738783900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Power House Psychotherapy & Addiction, Llc 654 Mount Prospect Ave Ste 201 Newark NJ 07104-3110 Ph: (973) 878-3900 | Power House Psychotherapy & Addiction, Llc 654 Mount Prospect Ave Ste 201 Newark NJ 07104-3110 Ph: (862) 888-8146 |
| NPI Number | 1003330846 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 07/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003330846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 37LC00242600 (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | 44SC05667800 (New Jersey) | Secondary |
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