| Lakewood Community Services Corp. | |
|
225 4th St Lakewood NJ 08701-3228 | |
| (732) 901-6001 | |
| Not Available |
| Full Name | Lakewood Community Services Corp. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 225 4th St, Lakewood, New Jersey |
| Authorized Official Name and Position | Moshe Weisberg (PRESIDENT) |
| Authorized Official Contact | 7329016001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Community Services Corp. 450 W Kennedy Blvd Lakewood NJ 08701-1269 Ph: () - | Lakewood Community Services Corp. 225 4th St Lakewood NJ 08701-3228 Ph: (732) 901-6001 |
| NPI Number | 1093085649 |
|---|---|
| Provider Enumeration Date | 01/12/2012 |
| Last Update Date | 10/18/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 3274952114 |
|---|---|
| Medicare Enrollment ID | O20200928000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093085649 | NPI | - | NPPES |
| 0279579 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 101920204 (New Jersey) | Primary |
| Provider Name | Moses Gelfand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568760858 PECOS PAC ID: 3274796982 Enrollment ID: I20120516000453 |
| Provider Name | Gloria Rotberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083035661 PECOS PAC ID: 7012336977 Enrollment ID: I20200928001287 |
| Provider Name | Toby Kantor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063820975 PECOS PAC ID: 7618388299 Enrollment ID: I20201203001228 |
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