| Lifecycle Therapeutic Services Limited Liability Company | |
|
349 Franklin Ave Suite 201 Nutley NJ 07110-4004 | |
| (973) 517-4062 | |
| Not Available |
| Full Name | Lifecycle Therapeutic Services Limited Liability Company |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 349 Franklin Ave, Nutley, New Jersey |
| Authorized Official Name and Position | Amanda Levy (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9735714062 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifecycle Therapeutic Services Limited Liability Company 349 Franklin Ave Suite 201 Nutley NJ 07110-4004 Ph: (973) 517-4062 | Lifecycle Therapeutic Services Limited Liability Company 349 Franklin Ave Suite 201 Nutley NJ 07110-4004 Ph: (973) 517-4062 |
| NPI Number | 1700132933 |
|---|---|
| Provider Enumeration Date | 07/25/2012 |
| Last Update Date | 07/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700132933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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