NPIMap

Organization Active NPI

Children's Crisis Treatment Center

  • Adolescent and Children Mental Health Clinic/Center
  • Camden, NJ
National Provider Identifier
1902565609
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CHILDREN'S CRISIS TREATMENT CENTER
Practice address
525 Clinton St
Camden, NJ 08103-1223
Phone
(215) 496-0707
NPI assigned
Dec 10, 2021
Last updated
Dec 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Dr. Andrea S. Ettingoff, PH.D.
Title
Director of Clinical and Quality
Phone
(215) 496-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

525 Clinton St
Camden, NJ 08103-1223

Mailing address

1080 N Delaware Ave Ste 600
Philadelphia, PA 19125-4339
Phone (215) 496-0707

National Provider Directory

National Provider Directory
Tax ID family
Children's Crisis Treatment Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1080 N Delaware Ave
Ste 600
Philadelphia, PA 19125
Phone (215) 496-0707

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1902565609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 N DELAWARE AVE STE 600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191254339",
            "telephone_number": "215-496-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 CLINTON ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031223",
            "telephone_number": "215-496-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CRISIS TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "ETTINGOFF",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL AND QUALITY",
        "authorized_official_telephone_number": "215-496-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.