Organization
EMPOWERMENT THROUGH ADVENTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER K WIRTH LCSW (OWNER)
(609) 828-2110
Entity
Organization
Contact information
Practice address
86 ELGIN AVENUE, WESTMONT, NJ 08108
(609) 828-2110
(856) 854-5423
Mailing address
86 ELGIN AVENUE, WESTMONT, NJ 08108
(609) 828-2110
(856) 869-2830
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05230400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030856
—
NJ
05
—
0031101
—
NJ
05
—
0037494
—
NJ
Enumeration date
03/16/2007
Last updated
04/23/2008
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