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General NPI Number Information
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NPI Number | 1699815126
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Entity Type | Organization
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Legal Business Name | AT HOME MARITAL AND FAMILY COUNSELING SERVICE
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 6 BRUNSWICK WOODS DR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5601
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Country | US
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Telephone | 732-787-2010
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Fax | 732-787-1043
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Provider Business Mailing Address
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Address Line | 6 BRUNSWICK WOODS DR
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5601
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Country | US
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Telephone | 732-787-2010
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Fax | 732-787-1043
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Authorized Official
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Title or Position | LICENSED MFT SOLE PROPRIETOR
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Name | MS. LORRAINE BARRY
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Credential | ED.S.
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Telephone | 732-787-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F1001437
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License Number State | NJ
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