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General NPI Number Information
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NPI Number | 1578852844
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Entity Type | Individual
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Provider Name | TARA CELESTE WALTERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 100 HORIZON CENTER BLVD FL 1
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City | HAMILTON
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State | NJ
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Zip | 08691-1910
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Country | US
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Telephone | 609-222-4221
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Fax |
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Provider Business Mailing Address
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Address Line | 14 HOFFMAN DRIVE
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City | HAMILTON
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State | NJ
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Zip | 08690
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Country | US
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Telephone | 609-273-5702
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Fax | 609-838-1756
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC04758600
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License Number State | NJ
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