Provider Demographics
NPI:1033397229
Name:CMD MENTAL HEALTH PROFESSIONAL, INC
Entity Type:Organization
Organization Name:CMD MENTAL HEALTH PROFESSIONAL, INC
Other - Org Name:THE LISTENING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUZENSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-264-1717
Mailing Address - Street 1:739 WYNGATE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2434
Mailing Address - Country:US
Mailing Address - Phone:856-264-1717
Mailing Address - Fax:856-782-0712
Practice Address - Street 1:739 WYNGATE RD
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-2434
Practice Address - Country:US
Practice Address - Phone:856-264-1717
Practice Address - Fax:856-782-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)