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General NPI Number Information
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NPI Number | 1346571668
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Entity Type | Individual
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Provider Name | MICHELE H PITZER MSW
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 06/03/2012
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Provider Practice Location Address
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Address Line | 10 FAIRMOUNT AVE BREAKING THE CHAIN COUNSELING, LLC
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City | CHATHAM
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State | NJ
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Zip | 07928-2343
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Country | US
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Telephone | 732-450-0533
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Fax | 732-787-5717
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Provider Business Mailing Address
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Address Line | 651 MONMOUTH AVE BREAKING THE CHAIN COUNSELING, LLC
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City | PORT MONMOUTH
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State | NJ
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Zip | 07758-1517
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Country | US
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Telephone | 732-450-0533
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Fax | 732-787-5717
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 44SC05185500
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License Number State | NJ
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