=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831051481
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VCSNJ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2025
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22 GORDON AVE
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-1033
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-844-0452
-----------------------------------------------------
Fax | 609-844-0518
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 6573
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-0573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-844-0452
-----------------------------------------------------
Fax | 609-844-0518
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MBR
-----------------------------------------------------
Name | ELIZABETH ALBERTS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 609-844-0452
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------