Provider Demographics
NPI:1538603774
Name:CATHY NOBLICK PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:CATHY NOBLICK PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:NOBLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:732-380-0012
Mailing Address - Street 1:39 AVENUE AT THE CMN
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4807
Mailing Address - Country:US
Mailing Address - Phone:732-380-0012
Mailing Address - Fax:732-380-0019
Practice Address - Street 1:39 AVENUE AT THE CMN
Practice Address - Street 2:SUITE 106
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4807
Practice Address - Country:US
Practice Address - Phone:732-380-0012
Practice Address - Fax:732-380-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00166900251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health