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Contact Information

THERACORP, LLC
79 E RAILROAD AVE
JAMESBURG, NJ08831-1207
 Phone: 732-561-8555
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
 

Counselor

101Y00000X
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for THERACORP, LLC

NPI # 1063947828
LBN Legal business name THERACORP, LLC
Authorized official ALLA KRUTYANSKY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/28/2017
Last updated 11/11/2021 - About 5 years ago
Identifiers
NJ License # 101Y00000X
NJ License # 101YA0400X
NJ License # 101YM0800X
NJ License # 103T00000X
NJ License # 103TP0016X
NJ License # 1041X0700X
NJ License # 104200000X
NJ License # 106H00000X
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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