| Therapeutic Self Care | |
|
427 S Xanthus Ave Galloway NJ 08205-4642 | |
| (609) 328-0775 | |
| Not Available |
| Full Name | Therapeutic Self Care |
|---|---|
| Speciality | Counselor |
| Location | 427 S Xanthus Ave, Galloway, New Jersey |
| Authorized Official Name and Position | Gabriela Catalina Lopez (LPC/OWNER) |
| Authorized Official Contact | 6093280775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Self Care 427 S Xanthus Ave Galloway NJ 08205-4642 Ph: (609) 328-0775 | Therapeutic Self Care 427 S Xanthus Ave Galloway NJ 08205-4642 Ph: (609) 328-0775 |
| NPI Number | 1912570144 |
|---|---|
| Provider Enumeration Date | 07/24/2021 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0345604120 |
|---|---|
| Medicare Enrollment ID | O20230912003268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912570144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Carol S Kahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598886376 PECOS PAC ID: 7719884899 Enrollment ID: I20031217000138 |
| Provider Name | Gabriela Catalina Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538625546 PECOS PAC ID: 8426412206 Enrollment ID: I20240325001285 |
| Provider Name | Tanoa Darielle Bettis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275924334 PECOS PAC ID: 4082053764 Enrollment ID: I20240415000342 |
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