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Organization
MARVIN BEHAVIORAL HEALTH NJ PC
Active
Organization
MARVIN BEHAVIORAL HEALTH NJ PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSIE CLAUGHTON (PRESIDENT)
(617) 249-6854
Entity
Organization
Contact information
Practice address
4136 DEL REY AVE STE 626, MARINA DEL REY, CA 90292-5604
(617) 249-6854
Mailing address
4136 DEL REY AVE STE 626, MARINA DEL REY, CA 90292-5604
(617) 249-6854
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/12/2021
Last updated
05/31/2022
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