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Organization
LIFECYCLE THERAPEUTIC SERVICES LIMITED LIABILITY COMPANY
Active
Organization
LIFECYCLE THERAPEUTIC SERVICES LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LEVY LCSW (EXECUTIVE DIRECTOR)
(973) 571-4062
Entity
Organization
Contact information
Practice address
349 FRANKLIN AVE, SUITE 201, NUTLEY, NJ 07110-4004
(973) 517-4062
Mailing address
349 FRANKLIN AVE, SUITE 201, NUTLEY, NJ 07110-4004
(973) 517-4062
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/25/2012
Last updated
07/31/2012
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