Provider Demographics
NPI:1831330653
Name:CONTEXTUAL FAMILY THERAPY OF SOUTH JERSEY
Entity type:Organization
Organization Name:CONTEXTUAL FAMILY THERAPY OF SOUTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A HULSE
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:609-781-0441
Mailing Address - Street 1:49 SAINT MIHIEL DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1037
Mailing Address - Country:US
Mailing Address - Phone:609-781-0441
Mailing Address - Fax:
Practice Address - Street 1:29 S BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4655
Practice Address - Country:US
Practice Address - Phone:856-853-9300
Practice Address - Fax:856-461-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00148600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty