Healthcare Provider Details
I. General information
NPI: 1407690134
Provider Name (Legal Business Name): CHRISTOPHER JOHN HADFIELD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/19/2024
Last Update Date: 06/19/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
932 STATE RD
PRINCETON NJ
08540-1445
US
IV. Provider business mailing address
PO BOX 3101
TRENTON NJ
08619-0101
US
V. Phone/Fax
- Phone: 609-403-6190
- Fax: 609-403-6191
- Phone: 609-851-1289
- Fax: 609-403-6191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 44SC05996900 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: