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General NPI Number Information
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NPI Number | 1396290151
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Entity Type | Organization
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Legal Business Name | LIFE SEVA, COUNSELING AND CONSULTATION SERVICES
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 33 3RD ST STE 205
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1369
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Country | US
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Telephone | 732-895-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 33 3RD ST STE 205
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1369
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Country | US
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Telephone | 732-895-5288
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. MOBIN CHADHA
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Credential | LCSW
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Telephone | 732-895-5288
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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 | 44SC05675400
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License Number State | NJ
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