Provider Demographics
NPI:1033509401
Name:INTEGRATIVE THERAPY INSTITUTE NEW JERSEY
Entity type:Organization
Organization Name:INTEGRATIVE THERAPY INSTITUTE NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOLLENBACH
Authorized Official - Suffix:I
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-902-2181
Mailing Address - Street 1:400 NEW DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1724
Mailing Address - Country:US
Mailing Address - Phone:732-902-2181
Mailing Address - Fax:732-902-2182
Practice Address - Street 1:400 NEW DURHAM RD
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1724
Practice Address - Country:US
Practice Address - Phone:732-902-2181
Practice Address - Fax:732-902-2182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty