Provider Demographics
NPI:1467619486
Name:V MARGARET NEWMAN THERAPEUTIC SERVICE LLC
Entity Type:Organization
Organization Name:V MARGARET NEWMAN THERAPEUTIC SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-952-2688
Mailing Address - Street 1:4646 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-1849
Mailing Address - Country:US
Mailing Address - Phone:856-952-2688
Mailing Address - Fax:856-488-6222
Practice Address - Street 1:215 HIGHLAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2634
Practice Address - Country:US
Practice Address - Phone:856-952-2688
Practice Address - Fax:856-488-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05240200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0043206Medicaid