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NPI Code Detail

MEDICARE: MR. JOHN K. TODD MA, LCADC

MEDICARE: MR. JOHN K. TODD MA, LCADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00085200NJ

General Provider Information

NPI Number : 1093772931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN K. TODD MA, LCADC
Provider Business Mailing Address
First Line : 205 S EAST AVE
Second Line :
City : WENONAH
State : NJ
Zip : 08090-1919
Country : US
Telephone Number : 856-464-0662
Fax Number : 610-497-7244
Provider Business Practice Location Address
First Line : 205 S EAST AVE
Second Line :
City : WENONAH
State : NJ
Zip : 08090-1919
Country : US
Telephone Number : 856-464-0662
Fax Number : 610-497-7244
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/08/2007

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