Organization
CHANGES A PSYCHOTHERAPEUTIC PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS ALTAFFER LCSW (OWNER)
(609) 653-0665
Entity
Organization
Contact information
Practice address
505 HAMILTON AVE, SUITE 103, LINWOOD, NJ 08221-1057
(609) 653-0665
(609) 926-8697
Mailing address
411 W EDGEWOOD AVE, LINWOOD, NJ 08221-1709
(609) 653-0665
(609) 926-8697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC01453300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7704433
AETNA
NJ
Enumeration date
05/19/2007
Last updated
08/22/2020
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