Healthcare Provider Details

I. General information

NPI: 1497149041
Provider Name (Legal Business Name): J&T BEHAVIORAL HEALTH AND COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2015
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LIBERTY PL
SICKLERVILLE NJ
08081-5715
US

IV. Provider business mailing address

700 LIBERTY PL
SICKLERVILLE NJ
08081-5715
US

V. Phone/Fax

Practice location:
  • Phone: 856-776-7540
  • Fax:
Mailing address:
  • Phone: 856-776-7540
  • Fax: 856-776-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number26NJ00315300
License Number StateNJ

VIII. Authorized Official

Name: MR. JACOB NWOSU
Title or Position: MANAGER
Credential: PA-C
Phone: 856-776-7540