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General NPI Number Information
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NPI Number | 1538603774
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Entity Type | Organization
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Legal Business Name | CATHY NOBLICK PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 39 AVENUE AT THE CMN SUITE 106
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4807
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Country | US
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Telephone | 732-380-0012
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Fax | 732-380-0019
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Provider Business Mailing Address
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Address Line | 39 AVENUE AT THE CMN SUITE 106
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4807
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Country | US
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Telephone | 732-380-0012
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Fax | 732-380-0019
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Authorized Official
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Title or Position | OWNER
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Name | MS. CATHY L NOBLICK
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Credential | MSW, LCSW
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Telephone | 732-380-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44SC00166900
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License Number State | NJ
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