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General NPI Number Information
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NPI Number | 1912924887
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Entity Type | Organization
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Legal Business Name | FAMILY & CHILDRENS SRVCS OF CENTRAL NJ
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 JOHN ST STE 6
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City | PRINCETON
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State | NJ
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Zip | 08540
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Country | US
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Telephone | 609-924-7826
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Fax | 609-924-7826
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Provider Business Mailing Address
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Address Line | 120 JOHN ST STE 6
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City | PRINCETON
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State | NJ
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Zip | 08540
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Country | US
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Telephone | 609-924-2098
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Fax | 609-924-7826
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MARY L BALLARD
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Credential | MBA
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Telephone | 609-924-2098
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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 | 44SC05172100
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License Number State | NJ
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