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NPI Code Detail

MEDICARE: CHILD & ADOLESCENT PSYCHOLOGICAL SERVICES LLC

MEDICARE: CHILD & ADOLESCENT PSYCHOLOGICAL 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
1251S00000XCommunity/Behavioral Health AgencySI03913NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SI03913OTHERNJPSYCHOLOGY LICENSE

General Provider Information

NPI Number : 1538221650
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILD & ADOLESCENT PSYCHOLOGICAL SERVICES LLC
Provider Business Mailing Address
First Line : PO BOX 1004
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08034-0001
Country : US
Telephone Number : 856-321-1123
Fax Number : 856-427-0757
Provider Business Practice Location Address
First Line : 900 KINGS HWY N
Second Line : SUITE 201
City : CHERRY HILL
State : NJ
Zip : 08034-1516
Country : US
Telephone Number : 856-321-1123
Fax Number : 856-427-0757
Authorized Official
Title or Position : PRESIDENT
Name : DR. RHONA W. BROWN
Credential : PH.D.
Telephone Number : 856-427-0757
Provider Enumeration Date : 12/14/2006
Last Update Date : 08/22/2020

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