Provider Demographics
NPI:1588960975
Name:SPECTRUM CARE MANAGEMENT AND COUNSELING, LLC
Entity type:Organization
Organization Name:SPECTRUM CARE MANAGEMENT AND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BENEDETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERSACI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-530-4155
Mailing Address - Street 1:65 RAMAPO VALLEY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1182
Mailing Address - Country:US
Mailing Address - Phone:973-530-4155
Mailing Address - Fax:973-273-4797
Practice Address - Street 1:65 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1100
Practice Address - Country:US
Practice Address - Phone:973-530-4155
Practice Address - Fax:973-273-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health