Provider Demographics
NPI:1679303317
Name:FAMILY & COMMUNITY GROWTH CENTER
Entity type:Organization
Organization Name:FAMILY & COMMUNITY GROWTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONITIRI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LCADC
Authorized Official - Phone:609-807-8304
Mailing Address - Street 1:269 CLAFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-2356
Mailing Address - Country:US
Mailing Address - Phone:609-807-8304
Mailing Address - Fax:
Practice Address - Street 1:341 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2512
Practice Address - Country:US
Practice Address - Phone:609-807-8304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or Charitable
No405300000XOther Service ProvidersPrevention Professional