Provider Demographics
NPI:1568262426
Name:ELITE NETWORK PSYCHOTHERAPY
Entity type:Organization
Organization Name:ELITE NETWORK PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN-VON REICHE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-460-0099
Mailing Address - Street 1:584 ROUTE 17 NORTH
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-556-8210
Mailing Address - Fax:201-857-3015
Practice Address - Street 1:584 ROUTE 17 NORTH
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-556-8210
Practice Address - Fax:201-857-3015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TRANSFORMATION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty