Organization
FAMILY THERAPY AND CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY KLINE GOLD (PRESIDENT/CEO)
(856) 332-4698
Entity
Organization
Contact information
Practice address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 332-4698
(856) 415-7574
Mailing address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 332-4698
(856) 415-7574
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00150900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0046132
—
NJ
05
—
397539
—
NJ
Enumeration date
11/28/2017
Last updated
06/16/2018
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