Agnes Raeven in Sparta - Addiction (substance Use Disorder)
Agnes Raeven - NPI 1700917820
Agnes Raeven is a Addiction (substance Use Disorder) in Sparta, New Jersey. Agnes Raeven practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Agnes Raeven is 1700917820. The last update date is 2013-10-09.
Agnes Raeven's current location address is 3 Theatre Ctr, Sparta, New Jersey. You can contact this provider via phone number 9737293722 and fax number 5702962043. The mailing address for Agnes Raeven is 3 Theatre Ctr, Sparta, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Agnes Raeven |
|---|---|
| Address | 3 Theatre Ctr, Sparta, New Jersey |
| Phone Number | 9737293722 |
| Fax Number | 5702962043 |
| Sole Proprietor | Y |
| Credentials | ACSW, LCSW |
NPI Number Detail
| NPI Number | 1700917820 |
|---|---|
| Provider Enumeration Date | 2007-03-08 |
| Last Updated Date | 2013-10-09 |
Provider Mailing Address Detail
| Address | 3 Theatre Ctr |
|---|---|
| City | Sparta |
| State | New Jersey (NJ) |
| Post Code | 78712410 |
| Phone Number | 9737293722 |
| Fax Number | 5702962043 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 103Ta0400X |
| Licence No | SCO8663 |
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Definition: A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., ga |
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What is the unique identifier code issued to Agnes Raeven by the Centers for Medicare & Medicaid Services?
The Agnes Raeven has been assigned the NPI (National Provider Identifier) 1700917820. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Agnes Raeven?
The Agnes Raeven is situated at 3 Theatre Ctr, in the city of Sparta, state of NJ, with the zip code 78712410.
What is Agnes Raeven's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Agnes Raeven's specialized field of practice is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this area of specialization is 103Ta0400X.
On what date did Agnes Raeven receive its 1700917820 assignment from the Centers for Medicare & Medicaid Services?
The Agnes Raeven was assigned its 1700917820 on 2007-03-08, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Agnes Raeven most recently updated or revised?
The information pertaining to Agnes Raeven, including its address, specialty, and other relevant details, was last updated or revised on 2013-10-09.