Provider Demographics
NPI:1376396655
Name:AGAPE ABBY BOXMAN LCSW LLC
Entity Type:Organization
Organization Name:AGAPE ABBY BOXMAN LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:AGAPE
Authorized Official - Middle Name:ABBY
Authorized Official - Last Name:BOXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-471-1087
Mailing Address - Street 1:63 STOCKTON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2322
Mailing Address - Country:US
Mailing Address - Phone:917-471-1097
Mailing Address - Fax:
Practice Address - Street 1:550 KINDERKAMACK RD STE 123
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1500
Practice Address - Country:US
Practice Address - Phone:917-471-1087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty