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Organization

CHILDREN'S CONTINUUM OF CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY C. PETKA LMFT (EXECUTIVE DIRECTOR)
(856) 661-1100
Entity
Organization

Contact information

Practice address
177 S CENTRE ST, SUITE B, MERCHANTVILLE, NJ 08109-2220
(856) 661-1100
(856) 661-0910
Mailing address
177 S CENTRE ST, SUITE B, MERCHANTVILLE, NJ 08109-2220
(856) 661-1100
(856) 661-0910

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37FI00158500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0098965
NJ
Enumeration date
02/28/2007
Last updated
08/22/2020
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