Organization
TABULA RASA PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER CHARICE SUMERLIN PSYD, LMFT (LIC. MARRIAGE & FAMILY THERAPIST)
(973) 637-0375
Entity
Organization
Contact information
Practice address
190 WILEY AVE, PLAINFIELD, NJ 07062-1343
(973) 637-0375
Mailing address
190 WILEY AVE, PLAINFIELD, NJ 07062-1343
(973) 637-0375
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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