Provider Demographics
NPI:1083489678
Name:G. INNOCENTE & ASSOCIATES INSTITUTE OF PSYCHOTHERAPY
Entity Type:Organization
Organization Name:G. INNOCENTE & ASSOCIATES INSTITUTE OF PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:INNOCENTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-287-2559
Mailing Address - Street 1:10 E NEW YORK AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2367
Mailing Address - Country:US
Mailing Address - Phone:609-788-0771
Mailing Address - Fax:
Practice Address - Street 1:10 E NEW YORK AVE STE 5
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2367
Practice Address - Country:US
Practice Address - Phone:609-788-0771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty