Provider Demographics
NPI:1699932897
Name:V. MARGARET NEWMAN THERAPEUTIC SERVICE, LLC
Entity type:Organization
Organization Name:V. MARGARET NEWMAN THERAPEUTIC SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:NEWMAN-FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-952-2688
Mailing Address - Street 1:215 HIGHLAND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2634
Mailing Address - Country:US
Mailing Address - Phone:856-952-2688
Mailing Address - Fax:856-488-6222
Practice Address - Street 1:215 HIGHLAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2634
Practice Address - Country:US
Practice Address - Phone:856-952-2688
Practice Address - Fax:856-488-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05240200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
128519Y5JOtherMEDICARE PTAN (INDIVIDUAL)
NJ0043192Medicaid
NJ798708OtherAETNA
NJ807459000OtherMAGELLAN HEALTH SERVICES
128520OtherMEDICARE PTAN (GROUP)
PA2623548000OtherBLUE CROSS