South Broad Street Counseling Services Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

2000283 Issued in NJ

Legal business name

SOUTH BROAD STREET COUNSELING SERVICES INC

Practice address

1418 South Broad Street
Trenton, NJ 08610

Phone

(609) 394-8000

NPI assigned

Jul 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Clinton H Scott, PHD

Title

Executive Director

Phone

(609) 394-8000

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003014663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 SOUTH BROAD STREET",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08610",
            "telephone_number": "609-394-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 SOUTH BROAD STREET",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08610",
            "telephone_number": "609-394-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROAD STREET COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "609-394-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NJ",
            "license": "2000283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAI PROVIDER  NUMBER",
            "identifier": "0006033",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8937401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rabia Iqbal Soomro, M.D.
• Phiraphan Soontharothai, MD
• Lisa Angeline Sortino-Sowa, CRNP
• Anasse Souidi, M.D
• Nina Soukhanovskii, PHARMD
• Sovereign Care Services
• Sovereign Care Services
• Stephanie Sparacio, LSW
• Brittany Spielberger
• Justine M Sponziello, RN

• Health Service Clinic/Center in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Health Service Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.