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General NPI Number Information
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NPI Number | 1376396655
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Entity Type | Organization
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Legal Business Name | AGAPE ABBY BOXMAN LCSW LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 550 KINDERKAMACK RD STE 123
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City | ORADELL
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State | NJ
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Zip | 07649-1500
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Country | US
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Telephone | 917-471-1087
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Fax |
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Provider Business Mailing Address
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Address Line | 63 STOCKTON ST
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City | HILLSDALE
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State | NJ
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Zip | 07642-2322
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Country | US
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Telephone | 917-471-1097
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Fax |
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Authorized Official
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Title or Position | OWNER/SOLE MBR
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Name | AGAPE ABBY BOXMAN
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Credential | LCSW
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Telephone | 917-471-1087
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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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