Provider Demographics
NPI:1689163479
Name:CENTER FOR INTIMATE RELATIONSHIPS L.L.C.
Entity Type:Organization
Organization Name:CENTER FOR INTIMATE RELATIONSHIPS L.L.C.
Other - Org Name:CENTER FOR INTIMATE RELATIONSHIPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CST
Authorized Official - Phone:856-577-5515
Mailing Address - Street 1:18 STRAWBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2002
Mailing Address - Country:US
Mailing Address - Phone:856-577-5515
Mailing Address - Fax:
Practice Address - Street 1:35 KINGS HWY E STE 103
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2009
Practice Address - Country:US
Practice Address - Phone:856-208-6443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053226001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty