Provider Demographics
NPI:1982021150
Name:THE AWARENESS PRACTICE LLC
Entity Type:Organization
Organization Name:THE AWARENESS PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL: MEMBER & MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LMFT
Authorized Official - Phone:609-610-5011
Mailing Address - Street 1:4 PINE KNOLL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-610-5011
Mailing Address - Fax:
Practice Address - Street 1:390 AMWELL RD
Practice Address - Street 2:SUITE 312, BUILDING 3
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1225
Practice Address - Country:US
Practice Address - Phone:609-610-5011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054275001041C0700X
NJ37FL00169200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty