Tree of Life Wellness Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04870000 Issued in NJ

Legal business name

TREE OF LIFE WELLNESS CENTER, LLC

Practice address

7 Cooper Ave
Suite a
Marlton, NJ 08053-2184

Phone

(856) 905-3540

NPI assigned

Oct 24, 2014

Organization subpart

No

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

Authorized official

Name

Katherine Kehoe, LCSWNPI 1316349624

Title

Owner

Phone

(856) 905-3540

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Kehoe, LCSW

  • Clinical Social Worker
  • Marlton, NJ
  • NPI 1316349624
  NPD (past) Authorized official

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1003211640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WILLOW RIDGE RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534906",
            "telephone_number": "856-905-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 COOPER AVE",
            "address_2": "SUITE A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532184",
            "telephone_number": "856-905-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "KEHOE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-905-3540",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04870000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.