Organization
COUNSELING & THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN SIRACUSA LCSW (CLINICIAN)
(609) 816-6670
Entity
Organization
Contact information
Practice address
450 TILTON RD STE 250, NORTHFIELD, NJ 08225-1260
(609) 334-4992
Mailing address
19 WABASH AVE, LINWOOD, NJ 08221-2000
(609) 816-6670
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05441000
NJ
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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