Healthcare Provider Details

I. General information

NPI: 1720028145
Provider Name (Legal Business Name): JEWISH FAMILY & VOCATIONAL SERVICES OF MIDDLESEX COUNTY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PERRINEVILLE RD STE 52
MONROE TOWNSHIP NJ
08831-4903
US

IV. Provider business mailing address

219 BLACK HORSE LN UNIT C
NORTH BRUNSWICK NJ
08902-4301
US

V. Phone/Fax

Practice location:
  • Phone: 609-395-7979
  • Fax: 609-395-7129
Mailing address:
  • Phone: 732-777-1940
  • Fax: 732-777-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM STOVER
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 732-777-1940