NPIMap

Organization Active NPI

Garden State Behavioar Health Services South LLC

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1932399060
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GARDEN STATE BEHAVIOAR HEALTH SERVICES SOUTH LLC
Practice address
2 Eves Dr
Suite 104
Marlton, NJ 08053-3193
Phone
(856) 797-8777
Fax
(856) 797-6764
NPI assigned
Jul 25, 2007
Last updated
Jul 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
John B Hudome, DCHNPI 1710009758
Title
Partner
Phone
(856) 797-8777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2 Eves Dr
Suite 104
Marlton, NJ 08053-3193

Mailing address

2 Eves Dr
Suite 104
Marlton, NJ 08053-3193
Phone (856) 797-8777

National Provider Directory

National Provider Directory

Locations

2 Eves Dr
Ste 104
Marlton, NJ 08053
Phone (856) 797-8777

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1932399060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EVES DR",
            "address_2": "SUITE 104",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533193",
            "telephone_number": "856-797-8777",
            "fax_number": "856-797-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EVES DR",
            "address_2": "SUITE 104",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533193",
            "telephone_number": "856-797-8777",
            "fax_number": "856-797-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE BEHAVIOAR HEALTH SERVICES SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "HUDOME",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "856-797-8777",
        "authorized_official_credential": "DCH"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.