| Family Therapy And Consultation Services | |
|
1 Lupton Ave Woodbury NJ 08096-5901 | |
| (856) 332-4698 | |
| (856) 415-7574 |
| Full Name | Family Therapy And Consultation Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1 Lupton Ave, Woodbury, New Jersey |
| Authorized Official Name and Position | Nancy Kline Gold (PRESIDENT) |
| Authorized Official Contact | 8563324698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Therapy And Consultation Services 1 Lupton Ave Woodbury NJ 08096-5901 Ph: (856) 693-5775 | Family Therapy And Consultation Services 1 Lupton Ave Woodbury NJ 08096-5901 Ph: (856) 332-4698 |
| NPI Number | 1730239450 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 1456790419 |
|---|---|
| Medicare Enrollment ID | O20240423004434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730239450 | NPI | - | NPPES |
| 6P2422 | Other | NJ | MEDICARE |
| 0046132 | Other | NJ | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0400067046 (New Jersey) | Primary |
| Provider Name | Kristina M Parkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144641739 PECOS PAC ID: 9133350176 Enrollment ID: I20140317000120 |
| Provider Name | Stephanie Eisenstein |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780195057 PECOS PAC ID: 3779923883 Enrollment ID: I20240508000150 |
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