Healthcare Provider Details

I. General information

NPI: 1699932897
Provider Name (Legal Business Name): V. MARGARET NEWMAN THERAPEUTIC SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HIGHLAND AVE SUITE C
HADDON TOWNSHIP NJ
08108-2634
US

IV. Provider business mailing address

215 HIGHLAND AVE SUITE C
HADDON TOWNSHIP NJ
08108-2634
US

V. Phone/Fax

Practice location:
  • Phone: 856-952-2688
  • Fax: 856-488-6222
Mailing address:
  • Phone: 856-952-2688
  • Fax: 856-488-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number44SC05240200
License Number StateNJ

VIII. Authorized Official

Name: MS. VALERIE MARGARET NEWMAN-FREEMAN
Title or Position: EXECUTIVE OFFICER
Credential: LCSW
Phone: 856-952-2688