Kitchen Table Therapy, LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SC00586800 Issued in NJ

Legal business name

KITCHEN TABLE THERAPY, LLC

Practice address

31 Newfield Street
East Orange, NJ 07017-5410

Phone

(201) 725-1807

NPI assigned

Sep 9, 2010

Organization subpart

No

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

Authorized official

Name

Charlene W Mason-Reese

Title

Healthcare Provider

Phone

(201) 725-1807

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1275840332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 NEWFIELD STREET",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070175410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 NEWFIELD STREET",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070175410",
            "telephone_number": "201-725-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITCHEN TABLE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "MASON-REESE",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "HEALTHCARE PROVIDER",
        "authorized_official_telephone_number": "201-725-1807"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC00586800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rosalyn N Kizer, LPN, BS
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• John Knoll
• Wen-Ting Ko, ANP-C

• Social Worker in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.