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General NPI Number Information
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NPI Number | 1841498508
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Entity Type | Organization
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Legal Business Name | COUNSELING & EDUCATION THROUGH THE LIFE SPAN
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Dates
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Enumeration Date | 07/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 615 HOPE RD STE 4B
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City | EATONTOWN
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State | NJ
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Zip | 07724-1273
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Country | US
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Telephone | 732-804-1147
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Fax | 732-534-4401
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Provider Business Mailing Address
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Address Line | PO BOX 1432
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City | EATONTOWN
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State | NJ
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Zip | 07724-1082
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Country | US
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Telephone | 732-804-1147
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Fax | 732-534-4401
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | KATHERINE L ORLOWSKI
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Credential | LCSW
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Telephone | 732-804-1147
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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 | 44SC05269900
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License Number State | NJ
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