Organization
FAMILY SERVICE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIE ECHO MSW (VP OF CLINICAL SERVICES)
(609) 569-0239
Entity
Organization
Contact information
Practice address
312 E WHITE HORSE PIKE, GALLOWAY, NJ 08205-9565
(609) 652-1600
(609) 652-2226
Mailing address
3073 ENGLISH CREEK AVE, STE 3, EGG HARBOR TWP, NJ 08234-9711
(609) 569-0239
(609) 569-1802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
N/A
NJ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024201
—
NJ
Enumeration date
05/16/2006
Last updated
02/24/2012
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