Healthcare Provider Details

I. General information

NPI: 1164726147
Provider Name (Legal Business Name): GLENDA LYNN BESCHEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 FRIES MILL RD. STE 201
TURNERSVILLE NJ
08012
US

IV. Provider business mailing address

151 FRIES MILL RD STE. 201
TURNERSVILLE NJ
08012
US

V. Phone/Fax

Practice location:
  • Phone: 856-745-8847
  • Fax: 856-270-2403
Mailing address:
  • Phone: 856-745-8847
  • Fax: 856-270-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00418800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: