Healthcare Provider Details

I. General information

NPI: 1275019994
Provider Name (Legal Business Name): ONWARD BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S WHITE HORSE PIKE
HAMMONTON NJ
08037
US

IV. Provider business mailing address

600 S WHITE HORSE PIKE
HAMMONTON NJ
08037
US

V. Phone/Fax

Practice location:
  • Phone: 609-270-4260
  • Fax:
Mailing address:
  • Phone: 866-546-9117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00259500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number25MA05448700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL06269600
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. TOM FOWLER
Title or Position: VP OF OPERATIONS
Credential: PSY.D.
Phone: 609-270-4260