Provider Demographics
NPI:1396871455
Name:TOTORA, SAMUEL BENJAMIN JR (LPC,LMFT)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:BENJAMIN
Last Name:TOTORA
Suffix:JR
Gender:M
Credentials:LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 MAYS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-8301
Mailing Address - Country:US
Mailing Address - Phone:609-457-3344
Mailing Address - Fax:609-567-5923
Practice Address - Street 1:1161 ROUTE 50
Practice Address - Street 2:BOX 160,
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-1511
Practice Address - Country:US
Practice Address - Phone:609-457-3344
Practice Address - Fax:609-567-5923
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC 02392101YP2500X
NJFI 01398106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ600004198OtherMAGELLAN MIS NUMBER
1366560591OtherNPI FOR FAMILY FOUNDATION