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General NPI Number Information
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NPI Number | 1124420302
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Entity Type | Organization
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Legal Business Name | KEDESH COUNSLING CENTER
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 2725 N DELSEA DR
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City | VINELAND
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State | NJ
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Zip | 08360-2184
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Country | US
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Telephone | 856-696-4380
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Fax | 856-696-0974
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Provider Business Mailing Address
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Address Line | 2630 E CHESTNUT AVE SUITE D-4
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City | VINELAND
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State | NJ
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Zip | 08361-8400
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Country | US
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Telephone | 856-696-4380
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Fax | 856-696-0974
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | ABBEY BRADWAY
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Credential | MSLPC,ACS
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Telephone | 856-696-5690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | NJ
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