Provider Demographics
NPI:1053590513
Name:BERGEN AWARE ASSESSMENT & COUNSELING
Entity type:Organization
Organization Name:BERGEN AWARE ASSESSMENT & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST ( BUSINESS OWNER )
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW,LCADC,CASAC
Authorized Official - Phone:201-686-4992
Mailing Address - Street 1:235 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7313
Mailing Address - Country:US
Mailing Address - Phone:201-686-4992
Mailing Address - Fax:
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-7313
Practice Address - Country:US
Practice Address - Phone:201-686-4992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04950400251B00000X
NJ37LC00038700251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management