Davis, Chanan

Davis, Chanan is an individual health care provider with primary practice located at 700 Airport Rd , Lakewood NJ 08701-5907. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Davis, Chanan can be contacted via phone (732) 367-4700.

Contact Information

Primary practice address
700 Airport Rd Lakewood NJ 08701-5907
Phone: (732) 367-4700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 37F100187200 New Jersey

Profile Details

NPI number 1194116566
LBN Legal business name Davis, Chanan
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2015
Last updated Oct 10th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194116566 NPPES
New Jersey MEDICAID 0029807

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