NPIMap

Organization Active NPI

Bordentown Counseling Center, LLC

  • Clinical Social Worker
  • Bordentown, NJ
National Provider Identifier
1710199559
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05197000 Issued in NJ
Legal business name
BORDENTOWN COUNSELING CENTER, LLC
Practice address
410 Farnsworth Ave
Suite 1a
Bordentown, NJ 08505-2005
Phone
(609) 298-9144
Fax
(609) 298-9288
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Mrs. Dana Peterson, LCSW
Title
Clinical Director
Phone
(609) 298-9144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 44SC05197000 NJ Primary

Addresses

Primary practice location

410 Farnsworth Ave
Suite 1a
Bordentown, NJ 08505-2005

Mailing address

410 Farnsworth Ave
Suite 1a
Bordentown, NJ 08505-2005
Phone (609) 298-9144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1710199559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FARNSWORTH AVE",
            "address_2": "SUITE 1A",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052005",
            "telephone_number": "609-298-9144",
            "fax_number": "609-298-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FARNSWORTH AVE",
            "address_2": "SUITE 1A",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052005",
            "telephone_number": "609-298-9144",
            "fax_number": "609-298-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORDENTOWN COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "609-298-9144",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05197000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bordentown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.