Provider Demographics
NPI:1649493404
Name:SOUTH JERSEY CENTER FOR PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:SOUTH JERSEY CENTER FOR PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:856-383-0585
Mailing Address - Street 1:20 S BROADWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-1434
Mailing Address - Country:US
Mailing Address - Phone:856-383-0585
Mailing Address - Fax:
Practice Address - Street 1:20 S BROADWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-1434
Practice Address - Country:US
Practice Address - Phone:856-383-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health