Montclair Memory Clinic Llc

LBN: Montclair Memory Clinic Llc
Montclair Memory Clinic Llc is an health care organization with primary practice located at 70 Park Street Suite 207, Montclair NJ 07042-2960. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is the primary health care specialty. Montclair Memory Clinic Llc can be contacted via phone (973) 743-4555, or through Rondeau, Jacqueline A via phone (973) 743-4555.

Contact Information

Primary practice address
70 Park Street Suite 207 Montclair NJ 07042-2960
Phone: (973) 743-4555
Fax: (973) 743-4055
Website:
Map and Directions
Authorized official contact:
Name: Rondeau, Jacqueline A PSYD
Phone: (973) 743-4555

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 35SI00390000 New Jersey
Behavioral Health & Social Service Providers / Clinical 103TC0700X 35SI00390000 New Jersey
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X

Profile Details

NPI number 1114396835
LBN Legal business name Montclair Memory Clinic Llc
DBA Doing business as
Authorized official Rondeau, Jacqueline A PSYD
Entity Organization
Organization subpart 1 No
Enumeration date Sep 23rd, 2015
Last updated Apr 15th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114396835 NPPES
New Jersey MEDICAID 0051560

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