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General NPI Number Information
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NPI Number | 1417937210
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Entity Type | Organization
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Legal Business Name | FAMILY GUIDANCE CENTER OF WARREN COUNTY
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 492 ROUTE 57 W
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City | WASHINGTON
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State | NJ
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Zip | 07882-4338
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Country | US
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Telephone | 908-689-1000
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Fax | 908-689-4529
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Provider Business Mailing Address
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Address Line | 492 ROUTE 57 W
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City | WASHINGTON
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State | NJ
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Zip | 07882
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Country | US
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Telephone | 908-689-1000
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Fax | 908-689-4529
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHELE EICHORN
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Credential | LCSW, LCADC
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Telephone | 908-689-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 105010104
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 105010204A
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1050103041
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License Number State | NJ
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