Organization
SUFFUSE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN NUSSBAUM (OWNER)
(732) 930-1255
Entity
Organization
Contact information
Practice address
701 CROSS ST, LAKEWOOD, NJ 08701-4029
(732) 267-5226
Mailing address
701 CROSS ST, LAKEWOOD, NJ 08701-4029
(732) 267-5226
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/05/2018
Last updated
04/10/2019
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