| NPI | 1639500101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES IDRIS WEBB Lincensed Clincal Social Worker 973-748-0847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00472100) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 44SC00854200) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |