NPI 1093579039 · live from the CMS NPI Registry
250 Highland Ave LLC
Social Worker, Clinical in Maplewood, NJ. National Provider Identifier 1093579039, active.
NPI record
| NPI | 1093579039 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 2115 Millburn Avenue, Maplewood, NJ 07040 |
| Practice phone | 973-592-1512 |
| Mailing address | 41 Watchung Plz Ste 189, Montclair, NJ 07042 |
| Enumerated | February 9, 2024 |
| Last updated | February 9, 2024 |
| Authorized official | William Carr, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.