Organization
GENUINE ME OF SOUTH JERSEY INC
Active
Other names
Genuine Me LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE R FADOOL MSW, LCSW (PRESIDENT)
(609) 828-0097
Entity
Organization
Contact information
Practice address
111 CHURCH RD, MARLTON, NJ 08053
(609) 828-0097
(856) 802-0885
Mailing address
3 CRANBURY HILL CT, MOUNT LAUREL, NJ 08054-4849
(609) 828-0097
(856) 802-0885
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05576600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450088977
NEW JERSERY CERTIFICATE OF INC (PROFIT)
NJ
Enumeration date
08/06/2014
Last updated
08/16/2016
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