Healthcare Provider Details

I. General information

NPI: 1679481386
Provider Name (Legal Business Name): SADE BETHEA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLBY AVE STE 19
STRATFORD NJ
08084-1000
US

IV. Provider business mailing address

1 COLBY AVE STE 19
STRATFORD NJ
08084-1000
US

V. Phone/Fax

Practice location:
  • Phone: 609-962-7223
  • Fax:
Mailing address:
  • Phone: 609-962-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SADE BETHEA
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 267-348-9056