AVITA ICARE - NPI 1821530148 - Psychologist in Fort Lee, NJ

Q: What is Avita Integrative Care, LLC's NPI number?

The NPI number for Avita Integrative Care, LLC is 1821530148. It was assigned to this organization in the NPPES registry on November 17, 2016. The provider is doing business as Avita Icare.

Q: What is Avita Integrative Care, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

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About Avita Icare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVITA ICARE (NPI 1821530148) is a healthcare organization registered as a clinical in Fort Lee, New Jersey and active in the NPI registry since November 2016. The organization lists Kalman Khodik, Owner/clinical Director, as its authorized official.

NPPES Registry Identity

NPI1821530148

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameAVITA INTEGRATIVE CARE, LLC

Location Address440 WEST ST STE 312Fort Lee, NJ 07024-5028

Mailing Address440 West St Ste 312Fort Lee, NJ 07024-5028 · (888) 242-2732 · Fax (888) 242-2732

Phone(888) 242-2732

Fax(888) 242-2732

Organization SubpartNo

Authorized OfficialKalman KhodikOwner/clinical Director · (888) 242-2732

Enumeration DateNovember 17, 2016

Last NPPES UpdateJune 13, 20222 updates tracked since enumeration

NPPES CertifiedJune 13, 2022

✔ NPI 1821530148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NJ · 0450041113

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologistTaxonomy 103T00000X · License 0450041113 (NJ), 021116 (NY)

440 WEST ST STE 312, Fort Lee, NJ 07024

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Other Names 1

Doing Business AsAvita Icare

Group Practice 2

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE KEHOE LCSW

Social Worker (Clinical)