Provider Demographics
NPI:1306484423
Name:SUMMIT PSYCHOTHERAPY ASSOCIATION
Entity type:Organization
Organization Name:SUMMIT PSYCHOTHERAPY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:KAUFMAN
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-347-6211
Mailing Address - Street 1:2 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4019
Mailing Address - Country:US
Mailing Address - Phone:908-347-6211
Mailing Address - Fax:
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-347-6211
Practice Address - Fax:908-242-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215343900OtherNPI TYPE 1