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General NPI Number Information
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NPI Number | 1982021150
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Entity Type | Organization
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Legal Business Name | THE AWARENESS PRACTICE LLC
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 390 AMWELL RD SUITE 312, BUILDING 3
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1225
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Country | US
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Telephone | 609-610-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PINE KNOLL DRIVE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-610-5011
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL: MEMBER & MANAGING MEMBER
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Name | CYNTHIA ELIZABETH LEACH
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Credential | MSW, LCSW, LMFT
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Telephone | 609-610-5011
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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 | 37FL00169200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05427500
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License Number State | NJ
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