Provider Demographics
NPI:1689155582
Name:DARBOUZE, LLC
Entity Type:Organization
Organization Name:DARBOUZE, LLC
Other - Org Name:NADIA DARBOUZE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBOUZE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:215-479-0774
Mailing Address - Street 1:1013 CUNNINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5358
Mailing Address - Country:US
Mailing Address - Phone:215-479-0774
Mailing Address - Fax:856-242-2955
Practice Address - Street 1:255 BROAD ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2724
Practice Address - Country:US
Practice Address - Phone:856-200-3522
Practice Address - Fax:856-242-2955
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
NJ44SC056939001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty