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General NPI Number Information
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NPI Number | 1538452883
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Entity Type | Individual
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Provider Name | BRADLEY MORDER LPC
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Gender | Male
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 501 IRON BRIDGE RD STE 6
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City | FREEHOLD
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State | NJ
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Zip | 07728-5305
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Country | US
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Telephone | 732-242-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 23 N DELSEA DR UNIT B
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City | CLAYTON
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State | NJ
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Zip | 08312-1637
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Country | US
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Telephone | 856-423-7000
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Fax | 856-423-0823
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC37TC00424100
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License Number State | NJ
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