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General NPI Number Information
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NPI Number | 1689163479
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTIMATE RELATIONSHIPS L.L.C.
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 35 KINGS HWY E STE 103
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2009
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Country | US
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Telephone | 856-208-6443
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Fax |
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Provider Business Mailing Address
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Address Line | 18 STRAWBRIDGE AVE
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City | HADDON TOWNSHIP
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State | NJ
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Zip | 08108-2002
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Country | US
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Telephone | 856-577-5515
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. CAROLYNN ARISTONE
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Credential | MSW, LCSW, CST
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Telephone | 856-577-5515
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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 | 44SC05322600
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License Number State | NJ
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