Provider Demographics
NPI:1225366644
Name:MARY JO ALBURTUS INC
Entity type:Organization
Organization Name:MARY JO ALBURTUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBURTUS
Authorized Official - Suffix:
Authorized Official - Credentials:MSWLCSW
Authorized Official - Phone:732-219-9388
Mailing Address - Street 1:205 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2009
Mailing Address - Country:US
Mailing Address - Phone:732-219-9388
Mailing Address - Fax:
Practice Address - Street 1:205 BROAD ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2009
Practice Address - Country:US
Practice Address - Phone:732-219-9388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004009001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty