Provider Demographics
NPI:1790157550
Name:CENTER FOR INTRAPERSONAL WELLNESS
Entity Type:Organization
Organization Name:CENTER FOR INTRAPERSONAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MNGR & LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEMMLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-359-2503
Mailing Address - Street 1:2 NORTH ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059
Mailing Address - Country:US
Mailing Address - Phone:917-359-2503
Mailing Address - Fax:
Practice Address - Street 1:2 NORTH ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059
Practice Address - Country:US
Practice Address - Phone:917-359-2503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055086001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty