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General NPI Number Information
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NPI Number | 1023711520
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Entity Type | Organization
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Legal Business Name | AJEM CONSOLIDATED, LLC
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 127 GROVE ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-1605
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Country | US
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Telephone | 908-347-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 127 GROVE ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-1605
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Country | US
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Telephone | 908-347-3447
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. ALEXIS JEMAL
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Credential | LCSW
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Telephone | 908-347-3447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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