Doctor Name: | KEITH COLBERT |
NPI Number: | 1003992512 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCADC, CCFC |
License Number: | F18736 |
Business Practice Address: | 21-29 Wagner Place Irvington, NJ - 071111861 |
Business Phone Number: | 9733993132 |
Business Fax Number: | 9733997552 |
Mailing Address: | 21-29 Wagner Place, IRVINGTON |
State: | NJ |
Postal Code: | 071111861 |
Phone Number: | 9733993132 |
Fax Number: | 9733997552 |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | F18736 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |