1881105534 NPI number — JOANNE ROBERTSON, LPC, ACS, LLC

Table of content: MEGHAN RENEE PARSONS LLMSW (NPI 1922598945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881105534 NPI number — JOANNE ROBERTSON, LPC, ACS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOANNE ROBERTSON, LPC, ACS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881105534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 CHARLES LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEWELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08080-2716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-430-2600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 EGG HARBOR RD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08080-9406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-292-5540
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ROBERTSON
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
GALLO
Authorized Official Title or Position:
LICENSED PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
856-292-5540

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X , with the licence number:  37PC00383000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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