Healthcare Provider Details

I. General information

NPI: 1760532345
Provider Name (Legal Business Name): NUTLEY FAMILY SERVICE BUREAU, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 CHESTNUT ST
NUTLEY NJ
07110-2311
US

IV. Provider business mailing address

169 CHESTNUT ST
NUTLEY NJ
07110-2311
US

V. Phone/Fax

Practice location:
  • Phone: 973-667-1884
  • Fax: 973-667-2285
Mailing address:
  • Phone: 973-667-1884
  • Fax: 973-667-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. KATHERINE CARMICHAEL
Title or Position: EXECUTIVE DIRECTOR
Credential: LSW
Phone: 973-667-1884