Provider Demographics
NPI:1821631987
Name:ROWAN COLLEGE OF SOUTH JERSEY - CUMBERLAND CAMPUS
Entity Type:Organization
Organization Name:ROWAN COLLEGE OF SOUTH JERSEY - CUMBERLAND CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & CHIEF ADMINISTRATI
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:PICCONE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:856-200-4547
Mailing Address - Street 1:3322 COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-200-4548
Mailing Address - Fax:856-690-0812
Practice Address - Street 1:3322 COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-200-4548
Practice Address - Fax:856-690-0812
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROWAN COLLEGE OF SOUTH JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty