Provider Demographics
NPI:1841472545
Name:DOVER FAMILY THERAPY
Entity type:Organization
Organization Name:DOVER FAMILY THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:PROF
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PORESKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-673-7305
Mailing Address - Street 1:1541 RTE 37 E STE D
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5717
Mailing Address - Country:US
Mailing Address - Phone:732-673-7305
Mailing Address - Fax:732-929-8915
Practice Address - Street 1:1541 RTE 37 E STE D
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5717
Practice Address - Country:US
Practice Address - Phone:732-673-7305
Practice Address - Fax:732-929-8915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty