Organization
ROAD FOR SUCCESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN CRAWFORD LSW, LCADC, CCS (DIRECTOR)
(201) 362-9360
Entity
Organization
Contact information
Practice address
9 BASIN DR STE 190, KEARNY, NJ 07032-6521
(201) 362-9360
Mailing address
1303 BRISTOL STATION CT APT 1303, CARTERET, NJ 07008-3092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598214843
—
NJ
Enumeration date
09/23/2019
Last updated
09/23/2019
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