| Supplanter Counseling & Mediation, Llc | |
|
1330 Parkway Ave Ste 7 Ewing NJ 08628-3006 | |
| (609) 454-3080 | |
| (609) 454-3078 |
| Full Name | Supplanter Counseling & Mediation, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1330 Parkway Ave Ste 7, Ewing, New Jersey |
| Authorized Official Name and Position | Jacqueline C Porter- Stewart (OWNER) |
| Authorized Official Contact | 6094543080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supplanter Counseling & Mediation, Llc 1330 Parkway Ave Ste 12 Ewing NJ 08628-3006 Ph: (609) 454-3080 | Supplanter Counseling & Mediation, Llc 1330 Parkway Ave Ste 7 Ewing NJ 08628-3006 Ph: (609) 454-3080 |
| NPI Number | 1124665708 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 04/29/2020 |
| Certification Date | 04/29/2020 |
| Medicare PECOS PAC ID | 2365856440 |
|---|---|
| Medicare Enrollment ID | O20210201002245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124665708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jacqueline C Porter-stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912169103 PECOS PAC ID: 7113905704 Enrollment ID: I20210201002472 |
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