Healthcare Provider Details

I. General information

NPI: 1992547749
Provider Name (Legal Business Name): THE PURPOSEPROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 ROGERS AVE
SOMERSET NJ
08873-2423
US

IV. Provider business mailing address

873 US ROUTE 1 # 1021
NORTH BRUNSWICK NJ
08902-3345
US

V. Phone/Fax

Practice location:
  • Phone: 973-714-6586
  • Fax:
Mailing address:
  • Phone: 973-714-6586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABIMBOLA AKEJU
Title or Position: CEO
Credential: LCSW
Phone: 973-714-6586