MEDICARE: CAMBRIDGE BEHAVIORAL SERVICES LLC

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
1	101YP2500X	Professional Counselor	37PC00338100	NJ

General Provider Information

NPI Number	:	1427422104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMBRIDGE BEHAVIORAL SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 660
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07963-0660
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6750 N ANDREWS AVE
Second Line	:	SUITE 200
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-2173
Country	:	US
Telephone Number	:	973-296-5225
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	MS. GISELLE CHANG
Credential	:	LPC
Telephone Number	:	973-296-5225

Provider Enumeration Date	:	11/18/2015
Last Update Date	:	11/18/2015

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