Healthcare Provider Details

I. General information

NPI: 1144512245
Provider Name (Legal Business Name): STRENGTH FOR GIRLHOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

22 HOWARD BLVD SUITE 101
MT ARLINGTON NJ
07856-1532
US

IV. Provider business mailing address

22 HOWARD BLVD SUITE 101
MT ARLINGTON NJ
07856-1532
US

V. Phone/Fax

Practice location:
  • Phone: 973-770-7600
  • Fax: 973-770-7601
Mailing address:
  • Phone: 973-770-7600
  • Fax: 973-770-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00355700
License Number StateNJ

VIII. Authorized Official

Name: MRS. JENNIFER A. JOHNSON
Title or Position: DIRECTOR
Credential: MA, LPC
Phone: 973-713-1788