Healthcare Provider Details

I. General information

NPI: 1437593365
Provider Name (Legal Business Name): SUPPORTIVE CAREER COUNSELING AND EMPLOYMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 FELLOWSHIP RD 2ND FLOOR
MOUNT LAUREL NJ
08054-1234
US

IV. Provider business mailing address

309 FELLOWSHIP RD 2ND FLOOR
MOUNT LAUREL NJ
08054-1234
US

V. Phone/Fax

Practice location:
  • Phone: 856-878-9340
  • Fax: 856-583-0389
Mailing address:
  • Phone: 856-878-9340
  • Fax: 856-583-0389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAWN MARTIN
Title or Position: CHAIRPERSON
Credential:
Phone: 856-878-9340