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NPI 1184238214

NPI 1184238214 : BROAD SESSIONS COUNSELING, LLC : OAKLYN, NJ

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General NPI Number Information
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    NPI Number           |    1184238214
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    Entity Type          |    Organization 
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    Legal Business Name  |    BROAD SESSIONS COUNSELING, LLC 
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Dates
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    Enumeration Date     |    09/05/2020
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    Last Update Date     |    09/05/2020
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Provider Practice Location Address
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    Address Line         |    14 HILLCREST AVE 
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    City                 |    OAKLYN
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    State                |    NJ
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    Zip                  |    08107-1432
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    Country              |    US
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    Telephone            |    609-617-0616
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14 HILLCREST AVE 
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    City                 |    OAKLYN
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    State                |    NJ
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    Zip                  |    08107-1432
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    Country              |    US
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    Telephone            |    609-617-0616
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MELISSA  SIMONINI 
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    Credential           |    LCSW
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    Telephone            |    609-617-0616
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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       |    
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    License Number State |    
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