NPIMap

Organization Active NPI

South Jesery Behavorial Resource

  • Community/Behavioral Health Agency
  • Camden, NJ
National Provider Identifier
1104002963
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTH JESERY BEHAVORIAL RESOURCE
Practice address
530 Cooper St
Camden, NJ 08102-1252
Phone
(856) 541-1700
Fax
(856) 225-1373
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Stephanie Kalise Crawley
Title
Mental Health Aide
Phone
(856) 541-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

530 Cooper St
Camden, NJ 08102-1252

Mailing address

530 Cooper St
Camden, NJ 08102-1252
Phone (856) 541-1700

Other names 1

  • costar Other name

National Provider Directory

National Provider Directory

Locations

530 Cooper St
Camden, NJ 08102
Phone (856) 541-1700

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1104002963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 COOPER ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021252",
            "telephone_number": "856-541-1700",
            "fax_number": "856-225-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 COOPER ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021252",
            "telephone_number": "856-541-1700",
            "fax_number": "856-225-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JESERY BEHAVORIAL RESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "CRAWLEY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "KALISE",
        "authorized_official_title_or_position": "MENTAL HEALTH AIDE",
        "authorized_official_telephone_number": "856-541-1700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "costar",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.