Provider Demographics
NPI:1255962742
Name:CENTERED HEALING AND WELLNESS LLC
Entity type:Organization
Organization Name:CENTERED HEALING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ENID
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-434-0317
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-0121
Mailing Address - Country:US
Mailing Address - Phone:914-434-0317
Mailing Address - Fax:
Practice Address - Street 1:401 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07063-1701
Practice Address - Country:US
Practice Address - Phone:914-434-0317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty