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General NPI Number Information
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NPI Number | 1003258799
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Entity Type | Organization
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Legal Business Name | NEW JERSEY ASSOCIATION FOR PSYCHOTHERAPY
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 2115 MILLBURN AVENUE SUITE 100-4
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City | MAPLEWOOD
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State | NJ
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Zip | 07040
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Country | US
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Telephone | 973-763-2222
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Fax | 973-324-9705
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Provider Business Mailing Address
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Address Line | 2115 MILLBURN AVENUE SUITE 100-4
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City | MAPLEWOOD
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State | NJ
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Zip | 07040
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Country | US
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Telephone | 973-763-2222
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Fax | 973-324-9705
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. CAROL S. WELSCH
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Credential | MSW, LMFT
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Telephone | 973-763-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 881176578
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37F100085600
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License Number State | NJ
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