Basic Information
| Provider Information | |||||||||
| NPI: | 1689033045 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WELNER | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MS, LCGC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MANDEL | ||||||||
| OtherFirstName: | SARA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 89 FRENCH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322356350 | ||||||||
| FaxNumber: | 7322357088 | ||||||||
| Practice Location | |||||||||
| Address1: | 89 FRENCH ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322356350 | ||||||||
| FaxNumber: | 7322357088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2016 | ||||||||
| LastUpdateDate: | 02/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 25MJ00004100 | NJ | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.