Psychiatric Associates of Southern NJ

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

26NJ00332200 Issued in NJ

Legal business name

PSYCHIATRIC ASSOCIATES OF SOUTHERN NJ

Practice address

188 Fries Mill Rd
Suite E3
Turnersville, NJ 08012-2015

Phone

(856) 885-8036

NPI assigned

Jan 21, 2012

Organization subpart

No

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

Authorized official

Name

Eboni Freeman, MSN, APN-BC

Title

Apn

Phone

(856) 885-8036

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327104000000",
    "number": "1295006344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GOSLING CT",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080814882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 FRIES MILL RD",
            "address_2": "SUITE E3",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122015",
            "telephone_number": "856-885-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES OF SOUTHERN NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-01-21",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "EBONI",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "856-885-8036",
        "authorized_official_credential": "MSN, APN-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "26NJ00332200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Turnersville, NJ
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• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2012; 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.