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NPI Code Detail

MEDICARE: MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC

MEDICARE: MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor37PC00358500NJ

General Provider Information

NPI Number : 1558753079
Entity Type Code : Organization
Provider Name (Legal Business Name) : MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC
Provider Business Mailing Address
First Line : 1215 LIVINGSTON AVE STE 7
Second Line :
City : NORTH BRUNSWICK
State : NJ
Zip : 08902-3840
Country : US
Telephone Number : 732-317-1902
Fax Number : 732-317-1903
Provider Business Practice Location Address
First Line : 1215 LIVINGSTON AVE STE 7
Second Line :
City : NORTH BRUNSWICK
State : NJ
Zip : 08902-3840
Country : US
Telephone Number : 732-317-1902
Fax Number : 732-317-1903
Authorized Official
Title or Position : THERAPIST
Name : DR. GODFRIED BANING
Credential : PSY.D ; PH.D, LPC
Telephone Number : 732-317-1902
Provider Enumeration Date : 02/19/2015
Last Update Date : 02/19/2015

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Directions to “MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC ” Practice Location

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