| Grateful Therapy | |
|
32 Village Ct Hazlet NJ 07730-1533 | |
| (732) 335-1675 | |
| (732) 335-1151 |
| Full Name | Grateful Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 32 Village Ct, Hazlet, New Jersey |
| Authorized Official Name and Position | Daniel Struble (PRESIDENT) |
| Authorized Official Contact | 7323351675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grateful Therapy 32 Village Ct Hazlet NJ 07730-1533 Ph: (732) 335-1675 | Grateful Therapy 32 Village Ct Hazlet NJ 07730-1533 Ph: (732) 335-1675 |
| NPI Number | 1770159188 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 06/03/2021 |
| Certification Date | 06/03/2021 |
| Medicare PECOS PAC ID | 1052787298 |
|---|---|
| Medicare Enrollment ID | O20221013001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770159188 | NPI | - | NPPES |
| 232764 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Daniel E Struble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114032588 PECOS PAC ID: 3577730324 Enrollment ID: I20120118000675 |
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