FULL HEART RECOVERY LLC NPI 1912397704

NPI Information

  • NPI: 1912397704
  • Provider Name: FULL HEART RECOVERY, LLC
  • Classification: Psychologist - 103TA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 543 VALLEY RD
    SUITE 6
    UPPER MONTCLAIR, NJ
    ZIP 07043
  • Phone: (973) 744-9130

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NPI Details

FULL HEART RECOVERY, LLC is an addiction (substance use disorder) psychologist in Upper Montclair, NJ. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. FULL HEART RECOVERY, LLC NPI is 1912397704. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

543 VALLEY RD
SUITE 6
UPPER MONTCLAIR, NJ
ZIP 07043-881
Phone: (973) 744-9130
Fax: (973) 863-2354

The provider's authorized official is Henry Srednicki .
The authorized official title is Member and has the following contact phone number (973) 744-9130.

The enumeration date for this NPI number is 1/31/2015 and was last updated on 1/31/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)03509NEW JERSEYYes

What is NPI?

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This page was last updated on: 3/30/2025

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