Provider Demographics
NPI:1295216059
Name:CONFIDENTIALISTENER LLC
Entity Type:Organization
Organization Name:CONFIDENTIALISTENER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PROFESSIONA
Authorized Official - Phone:609-837-9600
Mailing Address - Street 1:106 STRAUBE CTR BLVD STE F112
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534
Mailing Address - Country:US
Mailing Address - Phone:609-837-9600
Mailing Address - Fax:
Practice Address - Street 1:106 STRAUBE CTR BLVD STE F112
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-837-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00469000103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty