Healthcare Provider Details

I. General information

NPI: 1184133472
Provider Name (Legal Business Name): FAMILY GUIDANCE CENTER OF WARREN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MEMORIAL PKWY
PHILLIPSBURG NJ
08865-1580
US

IV. Provider business mailing address

492 ROUTE 57 W
WASHINGTON NJ
07882-4411
US

V. Phone/Fax

Practice location:
  • Phone: 908-454-4470
  • Fax: 908-454-5317
Mailing address:
  • Phone: 908-689-1000
  • Fax: 908-689-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number200000200
License Number StateNJ

VIII. Authorized Official

Name: MICHELE EICHORN
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW, LCADC
Phone: 908-689-1000