Healthcare Provider Details

I. General information

NPI: 1588805964
Provider Name (Legal Business Name): TEMADA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 LAKEWOOD RD SUITE 5
TOMS RIVER NJ
08753-6581
US

IV. Provider business mailing address

984 LAKEWOOD RD SUITE 5
TOMS RIVER NJ
08753-6581
US

V. Phone/Fax

Practice location:
  • Phone: 732-270-3005
  • Fax: 732-270-3350
Mailing address:
  • Phone: 732-270-3005
  • Fax: 732-270-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00086300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00201000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC01293000
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID FRIEDMAN
Title or Position: PARTNER
Credential: LCSW
Phone: 732-270-3005