Healthcare Provider Details

I. General information

NPI: 1013374784
Provider Name (Legal Business Name): INGRID NOEMI TEMPLETON LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INGRID HERNANDEZ

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MEMORIAL PKWY FAMILY GUIDANCE CENTER OF WARREN COUNTY
PHILLIPSBURG NJ
08865-1580
US

IV. Provider business mailing address

492 ROUTE 57 W FAMILY GUIDANCE CENTER OF WARREN COUNTY
WASHINGTON NJ
07882-4411
US

V. Phone/Fax

Practice location:
  • Phone: 908-454-4770
  • Fax: 908-454-5317
Mailing address:
  • Phone: 908-689-1000
  • Fax: 908-689-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06133800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05891200
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: