Organization Name: | KITCHEN TABLE COUNSELING, LLC |
NPI Number: | 1720405640 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLY CUZZOLA (CLINICAL SOCIAL WORKER) |
Mailing Address: | 115 Claremont Ave Colonia |
State: | NJ US |
Postal Code: | 070672919 |
Phone Number: | 7322595970 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2014 |
NPI Last Update Date: | 03/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC04740700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |