NPIMap

Organization Active NPI

Independence Family Therapy Enterprises

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1265244016
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INDEPENDENCE FAMILY THERAPY ENTERPRISES
Doing business as
INDEPENDENCE FAMILY THERAPY ENTERPRISES
Practice address
1 Eves Dr Ste 111
Marlton, NJ 08053-3125
Phone
(856) 883-0061
NPI assigned
Jan 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Jared Randiek, LCSW
Title
Ceo
Phone
(856) 427-1214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1 Eves Dr Ste 111
Marlton, NJ 08053-3125

Mailing address

1 Eves Dr Ste 111
Marlton, NJ 08053-3125
Phone (856) 883-0061

Other names 1

  • INDEPENDENCE FAMILY THERAPY ENTERPRISES Doing business as

National Provider Directory

National Provider Directory

Locations

1 Eves Dr
Ste 111
Marlton, NJ 08053
Phone (856) 223-7718

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1265244016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 111",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "856-883-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 111",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "856-883-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE FAMILY THERAPY ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "RANDIEK",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-427-1214",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDEPENDENCE FAMILY THERAPY ENTERPRISES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.