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General NPI Number Information
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NPI Number | 1750747127
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Entity Type | Organization
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Legal Business Name | GLENELLYN COMMUNICATIONS INC
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 933 STATE RT 23 STE5
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1047
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Country | US
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Telephone | 973-345-8410
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Fax |
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Provider Business Mailing Address
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Address Line | 26 QUARTZ LN
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City | PATERSON
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State | NJ
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Zip | 07501-3343
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Country | US
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Telephone | 973-345-8410
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING SERVICES
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Name | DR. EDWARD G LAMBRO
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Credential | PHD
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Telephone | 973-345-8410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00056700
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License Number State | NJ
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