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General NPI Number Information
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NPI Number | 1407717960
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR CLINICAL TRAINING AND PSYCHOTHERAPY
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Dates
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Enumeration Date | 11/22/2025
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 501 BAY AVE STE 108
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2554
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Country | US
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Telephone | 609-287-2559
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Fax |
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Provider Business Mailing Address
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Address Line | 109 CAROL RD
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City | LINWOOD
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State | NJ
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Zip | 08221-2501
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Country | US
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Telephone | 609-287-2559
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Fax |
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Authorized Official
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Title or Position | HEAD OF PRACTICE
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Name | DR. GINA INNOCENTE
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Credential | DSW, LCSW
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Telephone | 609-287-2559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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