Healthcare Provider Details
I. General information
NPI: 1306136874
Provider Name (Legal Business Name): THE POSTPARTUM STRESS & FAMILY WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 FRIES MILL RD SUITE 201
TURNERSVILLE NJ
08012-2016
US
IV. Provider business mailing address
151 FRIES MILL RD SUITE 201
TURNERSVILLE NJ
08012-2016
US
V. Phone/Fax
- Phone: 856-745-8847
- Fax: 856-270-2403
- Phone: 856-745-8847
- Fax: 856-270-2403
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KAREN
KLEIMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LCSW
Phone: 856-745-8847