Healthcare Provider Details

I. General information

NPI: 1396475315
Provider Name (Legal Business Name): CHARITY OKOYE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 WILLIAM ST
RAHWAY NJ
07065-4946
US

IV. Provider business mailing address

312 WILLIAM ST
RAHWAY NJ
07065-4946
US

V. Phone/Fax

Practice location:
  • Phone: 732-739-7505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: