Provider Demographics
NPI:1699958504
Name:GREATER TRENTON BEHAVIORAL HEALTHCARE
Entity type:Organization
Organization Name:GREATER TRENTON BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:609-396-4258
Mailing Address - Street 1:1001 SPRUCE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3957
Mailing Address - Country:US
Mailing Address - Phone:609-396-6788
Mailing Address - Fax:609-989-1245
Practice Address - Street 1:832 BRUNSWICK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-3829
Practice Address - Country:US
Practice Address - Phone:609-396-8877
Practice Address - Fax:609-396-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05275000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health