=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306136874
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE POSTPARTUM STRESS & FAMILY WELLNESS CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2011
-----------------------------------------------------
Last Update Date | 07/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 151 FRIES MILL RD SUITE 201
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-745-8847
-----------------------------------------------------
Fax | 856-270-2403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 151 FRIES MILL RD SUITE 201
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-745-8847
-----------------------------------------------------
Fax | 856-270-2403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. KAREN KLEIMAN
-----------------------------------------------------
Credential | MSW, LCSW
-----------------------------------------------------
Telephone | 856-745-8847
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------