Provider Demographics
NPI:1174784987
Name:HELP CLUB - PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:HELP CLUB - PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:INDUKURI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:866-441-1591
Mailing Address - Street 1:810 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1724
Mailing Address - Country:US
Mailing Address - Phone:866-441-1591
Mailing Address - Fax:866-441-1136
Practice Address - Street 1:1819 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2740
Practice Address - Country:US
Practice Address - Phone:866-441-1591
Practice Address - Fax:866-441-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00351700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty