Provider Demographics
NPI:1386152916
Name:A BROADER VIEW
Entity type:Organization
Organization Name:A BROADER VIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-604-8107
Mailing Address - Street 1:1108 HOOPER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8344
Mailing Address - Country:US
Mailing Address - Phone:732-604-8107
Mailing Address - Fax:
Practice Address - Street 1:1108 HOOPER AVE STE 2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8344
Practice Address - Country:US
Practice Address - Phone:732-604-8107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053520001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty