| Madeline Till Lcsw | |
|
11 S Fullerton Ave Montclair NJ 07042-6304 | |
| (973) 798-8336 | |
| Not Available |
| Full Name | Madeline Till Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 11 S Fullerton Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Madeline Till (PROPRIETOR) |
| Authorized Official Contact | 9737988336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madeline Till Lcsw 19 Oxford St Montclair NJ 07042-4907 Ph: () - | Madeline Till Lcsw 11 S Fullerton Ave Montclair NJ 07042-6304 Ph: (973) 798-8336 |
| NPI Number | 1528427424 |
|---|---|
| Provider Enumeration Date | 02/19/2016 |
| Last Update Date | 04/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528427424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05668600 (New Jersey) | Primary |
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