Provider Demographics
NPI:1851651681
Name:CJT BEHAVIORAL HEALTH OF SOUTH JERSEY, LLC
Entity Type:Organization
Organization Name:CJT BEHAVIORAL HEALTH OF SOUTH JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCKRITER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS, LPC, LCADC
Authorized Official - Phone:877-258-3003
Mailing Address - Street 1:53 BEAVER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 HARRISON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-5915
Practice Address - Country:US
Practice Address - Phone:877-258-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-27
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty