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General NPI Number Information
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NPI Number | 1073898607
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Entity Type | Organization
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Legal Business Name | INTEGRATED THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 985 PATTON ST
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-2285
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Country | US
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Telephone | 732-247-9772
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Fax | 732-247-5772
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Provider Business Mailing Address
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Address Line | 985 PATTON ST
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-2285
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Country | US
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Telephone | 732-247-9772
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Fax | 732-247-5772
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. DONNA GILCHRIST
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Credential | LCSW
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Telephone | 848-448-9152
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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 | 44SC04836500
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License Number State | NJ
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