| Kim Chan-baerman Lcsw Llc | |
|
309 S New York Rd Ste 12 Galloway NJ 08205-6024 | |
| (609) 992-8293 | |
| (609) 382-7777 |
| Full Name | Kim Chan-baerman Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 309 S New York Rd Ste 12, Galloway, New Jersey |
| Authorized Official Name and Position | Kim Chan-baerman (OWNER) |
| Authorized Official Contact | 6098002024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Chan-baerman Lcsw Llc 309 S New York Rd Ste 12 Galloway NJ 08205-6024 Ph: (609) 992-8293 | Kim Chan-baerman Lcsw Llc 309 S New York Rd Ste 12 Galloway NJ 08205-6024 Ph: (609) 992-8293 |
| NPI Number | 1417590977 |
|---|---|
| Provider Enumeration Date | 10/28/2019 |
| Last Update Date | 10/28/2019 |
| Medicare PECOS PAC ID | 6103253117 |
|---|---|
| Medicare Enrollment ID | O20200303001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417590977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kim Chan-baerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013446756 PECOS PAC ID: 9234408972 Enrollment ID: I20170712000060 |
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