Organization
STANFORD ANGELS CLEAR MIND AND WELLNESS LLC
Active
Parent organization
STANFORD ANGELS LLC
Other names
Stanford Angels LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STANFORD ANGELS LLC
Authorized official
MS. CATINA BURKETT LCSW (SOCIAL WORK CLINICAL SUPERVISOR)
(201) 814-2759
Entity
Organization
Contact information
Practice address
1600 SAINT GEORGES AVE STE 301, RAHWAY, NJ 07065-2713
(848) 336-0965
(908) 248-0804
Mailing address
1600 SAINT GEORGES AVE STE 301, RAHWAY, NJ 07065-2713
(848) 336-0965
(908) 248-0804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
08/20/2024
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