Provider Demographics
NPI:1255871307
Name:CLINICAL OFFICE FOR PROGRESS AND EMPOWERMENT
Entity type:Organization
Organization Name:CLINICAL OFFICE FOR PROGRESS AND EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-844-5828
Mailing Address - Street 1:PO BOX 110076
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-0902
Mailing Address - Country:US
Mailing Address - Phone:201-844-5828
Mailing Address - Fax:
Practice Address - Street 1:129 VALLEY RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2331
Practice Address - Country:US
Practice Address - Phone:201-844-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054773001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty