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General NPI Number Information
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NPI Number | 1063548907
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Entity Type | Organization
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Legal Business Name | THE STOCKNOFF CENTER FORGROWTH AND DEVELOPMENT, LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 20 ELM ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-8804
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Country | US
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Telephone | 973-868-6204
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Fax |
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Provider Business Mailing Address
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Address Line | 20 ELM ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-8804
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Country | US
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Telephone | 973-868-6204
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. ANN BETH STOCKNOFF
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Credential | LCSW
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Telephone | 973-868-6204
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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 | SC43092
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License Number State | NJ
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