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General NPI Number Information
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NPI Number | 1255917159
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Entity Type | Organization
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Legal Business Name | J. ADAMS PSYCHOTHERAPY
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 109 MAIN ST STE 1B
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1453
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Country | US
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Telephone | 862-345-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 109 MAIN ST STE 1B
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING CONSULTANT
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Name | ERICA PORTER
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Credential |
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Telephone | 443-255-3135
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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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