| Mrs Theresa L Black, LPC, NCC, ACS | |
|
333 Irving Ave, Capc First Floor, Bridgeton, NJ 08302-2123 | |
| (856) 575-4196 | |
| (856) 575-5071 |
| Full Name | Mrs Theresa L Black |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 333 Irving Ave, Bridgeton, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376802397 | NPI | - | NPPES |
| 3674509 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00324200 (New Jersey) | Primary |
| Entity Name | Center For Family Guidance Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508803388 PECOS PAC ID: 2860396454 Enrollment ID: O20031125000323 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Theresa L Black, LPC, NCC, ACS 333 Irving Ave, Capc First Floor, Bridgeton, NJ 08302-2123 Ph: (856) 575-4196 | Mrs Theresa L Black, LPC, NCC, ACS 333 Irving Ave, Capc First Floor, Bridgeton, NJ 08302-2123 Ph: (856) 575-4196 |
Ms. Annette Tolbert, Counselor Medicare: Not Enrolled in Medicare Practice Location: 90 South Burlington Rd, 189, Bridgeton, NJ 08302 Phone: 609-328-8845 | |
Simone Henry, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Cohansey St, Bridgeton, NJ 08302 Phone: 856-497-6650 | |
Ruby Aparicio-pagan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 269 Hampton St, Bridgeton, NJ 08302 Phone: 856-313-5956 | |
Ms. Jada Fields, Counselor Medicare: Not Enrolled in Medicare Practice Location: 333 Irving Ave, Bridgeton, NJ 08302 Phone: 856-575-4141 | |
Mrs. Amelia Wilmore-nozil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 113 Deerfield Dr, Bridgeton, NJ 08302 Phone: 571-210-8094 | |
Myangel A Davis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 162 Sunny Slope Dr, Bridgeton, NJ 08302 Phone: 856-455-5441 | |
Latasha Cohen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Manheim Ave, Bridgeton, NJ 08302 Phone: 856-537-2310 |