Organization
POWER HOUSE PSYCHOTHERAPY & ADDICTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEMITOPE SHAKIRAT COATES LCSW, LCADC, CCS (EXECUTIVE DIRECTOR/ADMINISTRATOR)
(973) 878-3900
Entity
Organization
Contact information
Practice address
654 MOUNT PROSPECT AVE STE 201, NEWARK, NJ 07104-3110
(862) 888-8146
Mailing address
654 MOUNT PROSPECT AVE STE 201, NEWARK, NJ 07104-3110
(973) 878-3900
(973) 878-3809
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00242600
—
1041C0700X
Clinical Social Worker
44SC05667800
NJ
Other
Enumeration date
08/02/2017
Last updated
07/21/2019
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