Healthcare Provider Details

I. General information

NPI: 1992398739
Provider Name (Legal Business Name): KS THERAPY AND CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 STRAUBE CENTER BLVD STE F114
PENNINGTON NJ
08534-1449
US

IV. Provider business mailing address

106 STRAUBE CENTER BLVD # C8
PENNINGTON NJ
08534-1449
US

V. Phone/Fax

Practice location:
  • Phone: 732-659-0496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KIMBERLY STOLOW
Title or Position: OWNER/THERAPIST
Credential:
Phone: 732-659-0496