Provider Demographics
NPI:1841589223
Name:GEANNINE M. LEBUDE LLC
Entity type:Organization
Organization Name:GEANNINE M. LEBUDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEANNINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEBUDE
Authorized Official - Suffix:
Authorized Official - Credentials:MSS LCSW
Authorized Official - Phone:856-874-9200
Mailing Address - Street 1:1930 EAST MARLTON PIKE
Mailing Address - Street 2:SUITE M69
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003
Mailing Address - Country:US
Mailing Address - Phone:856-874-9200
Mailing Address - Fax:856-874-9801
Practice Address - Street 1:1930 MARLTON PIKE E
Practice Address - Street 2:SUITE M69
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-874-9200
Practice Address - Fax:856-874-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC043287001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty