Park Bench Group Counseling, LLC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

200023007 Issued in NJ

Legal business name

PARK BENCH GROUP COUNSELING, LLC

Practice address

421 Bethel Rd
Somers Point, NJ 08244-2081

Phone

(609) 365-2601

Fax

(609) 365-2519

NPI assigned

Apr 6, 2007

Last updated

May 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Randi Massey-Alvarado, LCSW, LCADC

Title

Co-Owner

Phone

(609) 365-2601

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1487776738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 BETHEL RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442081",
            "telephone_number": "609-365-2601",
            "fax_number": "609-365-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BETHEL RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442081",
            "telephone_number": "609-365-2601",
            "fax_number": "609-365-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK BENCH GROUP COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MASSEY-ALVARADO",
        "authorized_official_first_name": "RANDI",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "609-365-2601",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, LCADC"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NJ",
            "license": "200023007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chelsea Paulin, REGISTERED DIETITIAN

• Rehabilitation Hospital in Somers Point, NJ
• Providers in Somers Point, NJ by specialty
• Rehabilitation Hospital in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.