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General NPI Number Information
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NPI Number | 1295015741
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Entity Type | Organization
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Legal Business Name | LIBERTY CORNER COUNSELING CENTER FOR RECOVERY
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Dates
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Enumeration Date | 08/27/2011
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Last Update Date | 08/27/2011
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Provider Practice Location Address
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Address Line | 44 ELM ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4110
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Country | US
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Telephone | 973-359-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 213 LIBERTY CORNER RD
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City | FAR HILLS
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State | NJ
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Zip | 07931-2568
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Country | US
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Telephone | 973-359-0662
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRITOR
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Name | BARBARA PAOLO
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Credential | LCADC
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Telephone | 973-359-0662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC000706000
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License Number State | NJ
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