Basic Information
| Provider Information | |||||||||
| NPI: | 1780140012 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WELLBEING PSYCHOLOGY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 433 | ||||||||
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| City: | WEST ORANGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070520433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3474505320 | ||||||||
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| Practice Location | |||||||||
| Address1: | 623 EAGLE ROCK AVE STE 1 | ||||||||
| Address2: | |||||||||
| City: | WEST ORANGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070522948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3474505320 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2019 | ||||||||
| LastUpdateDate: | 02/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | KHSHAIBOON | ||||||||
| AuthorizedOfficialFirstName: | SALMA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHOLOGIST/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2016583430 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.