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General NPI Number Information
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NPI Number | 1255871307
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Entity Type | Organization
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Legal Business Name | CLINICAL OFFICE FOR PROGRESS AND EMPOWERMENT
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 129 VALLEY RD 2ND FLOOR
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2331
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Country | US
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Telephone | 201-844-5828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110076
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City | NUTLEY
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State | NJ
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Zip | 07110-0902
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Country | US
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Telephone | 201-844-5828
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CHRISTINE MORALES
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Credential | LCSW
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Telephone | 201-844-5828
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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 | 44SC05477300
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License Number State | NJ
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