MRS. BRIDGET JUANIQUE LARK-ROEBUCK (NPI# 1386125946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386125946 |
| Entity Type | Individual |
| Full Name | MRS. BRIDGET JUANIQUE LARK-ROEBUCK |
| Credential | LMFT |
| Practice Address |
20 Berlin Rd Clementon NJ 08021-4546 |
| Mailing Address |
38 Walnut Ave Lindenwold NJ 08021-1635 |
| Practice Telephone | 8562207035 |
| Mailing Telephone | 8562207035 |
| Mailing Fax Number | 8563442449 |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 37FI00186600 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
20 BERLIN RD |
| City | CLEMENTON |
| State | NJ |
| Zip Code | 08021-4546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700850096 | Steven Wayne Forman | Podiatrist | 20 Berlin Rd, Clementon, NJ 08021-4546 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124663059 | Harmony Bay Wellness, LLC | Clinic/Center | 1387 Chews Landing Road, Laurel Springs, NJ 08021 | 2019-11-14 |
| 1134782576 | Mobile Dental Care of Delaware Pa | Dentist | 239 Cypress Ave, Lindenwold, NJ 08021 | 2019-04-22 |
| 1316441645 | Ability Advocates of New Jersey | Case Management | 1451 Chews Landing Rd, Suite 208, Clementon, NJ 08021 | 2018-03-21 |
| 1871007286 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 43 Park Boulevard, Clementon, NJ 08021 | 2017-11-21 |
| 1639697444 | Oaks Integrated Care | Clinic/Center | 1611 Hinder La, Clemmenton, NJ 08021 | 2017-08-31 |
| 1548785462 | Poonam Yadav | Dentist | 3, Kelly Drivers Ln, Laurel Springs, NJ 08021 | 2017-08-11 |
| 1669996468 | Arc of Camden County - Heather Sa | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1990 Laurel Road, Apt Ac-248, Lindenwold, NJ 08021 | 2017-08-02 |
| 1881118610 | Arc of Camden County- Millbridge Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 285 Millhurst Ct, Apt 258, Clementon, NJ 08021 | 2017-08-02 |
| 1710409982 | Leavy Healthcare Services, Inc. | Non-emergency Medical Transport (VAN) | 906 Mason Run, Pine Hill, NJ 08021 | 2017-07-10 |
| 1982134599 | Achieving A Better Life | Case Management | 1600 Laurel Road, E66, Lindenwold, NJ 08021 | 2017-06-15 |
| Find all providers in zip 08021 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325019 | Nicholas Joseph Spanola | Marriage & Family Therapist | 302 Hawthorne Ave Ste 1, Point Pleasant Beach, NJ 08742-2539 | 2020-10-29 |
| 1598362469 | Kathrine Evans | Marriage & Family Therapist | 216 Neptune Dr, Manahawkin, NJ 08050-1751 | 2020-10-05 |
| 1437756582 | Yung Cha | Marriage & Family Therapist | 180 Undercliff Ave, Edgewater, NJ 07020-1125 | 2020-10-01 |
| 1518574680 | Collaborative Connections LLC | Marriage & Family Therapist | 39 20th Ave Fl 2, Irvington, NJ 07111-4451 | 2020-09-23 |
| 1699381095 | Kenneth Young | Marriage & Family Therapist | 37 Sturgis Rd, Edison, NJ 08817-4039 | 2020-09-21 |
| 1114530060 | Alexander M Cicchino | Marriage & Family Therapist | 11 Cherokee Rd, Cranford, NJ 07016-3360 | 2020-08-28 |
| 1912525874 | Maria S Mora | Marriage & Family Therapist | 41 Marinus St, Rochelle Park, NJ 07662-3805 | 2020-07-08 |
| 1750908869 | Dolly Bosire | Marriage & Family Therapist | 2040 Millburn Ave Ste 303, Maplewood, NJ 07040-3716 | 2020-07-06 |
| 1265059067 | Fresh Start Family Therapy Services | Marriage & Family Therapist | 600 Somerdale Rd Ste 101, Voorhees, NJ 08043-1858 | 2020-06-29 |
| 1033734298 | Gurjot Mondair | Marriage & Family Therapist | 11 Thorn Briar Ln, Burlington, NJ 08016-5131 | 2020-06-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.