Provider Demographics
NPI:1932510187
Name:ADULT, CHILDREN AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:ADULT, CHILDREN AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:908-653-0005
Mailing Address - Street 1:45 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2686
Mailing Address - Country:US
Mailing Address - Phone:908-653-0005
Mailing Address - Fax:908-653-1806
Practice Address - Street 1:45 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2686
Practice Address - Country:US
Practice Address - Phone:908-653-0005
Practice Address - Fax:908-653-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001933001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
201004053601Medicare PIN