Provider Demographics
NPI:1124357942
Name:BURLINGTON COUNTY THERAPY
Entity Type:Organization
Organization Name:BURLINGTON COUNTY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:609-914-1700
Mailing Address - Street 1:774 EAYRESTOWN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048
Mailing Address - Country:US
Mailing Address - Phone:609-914-1700
Mailing Address - Fax:
Practice Address - Street 1:774 EAYRESTOWN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048
Practice Address - Country:US
Practice Address - Phone:609-914-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05332900251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ832321421OtherDUNS