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General NPI Number Information
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NPI Number | 1538952387
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Entity Type | Organization
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Legal Business Name | NURTURE GROUP
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 7301 HOLMAN AVE
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City | PENNSAUKEN
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State | NJ
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Zip | 08110-3416
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Country | US
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Telephone | 609-232-7323
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Fax |
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Provider Business Mailing Address
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Address Line | 1181 NIXON DR # 1187
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3201
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Country | US
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Telephone | 609-232-7323
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHEROLDE HACKETT
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Credential | LCSW
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Telephone | 609-828-9973
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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 | 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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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | 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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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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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