Healthcare Provider Details

I. General information

NPI: 1992315907
Provider Name (Legal Business Name): POND OF PEACE COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SUNNY LN
CAPE MAY COURT HOUSE NJ
08210-1005
US

IV. Provider business mailing address

30 SUNNY LN
CAPE MAY COURT HOUSE NJ
08210-1005
US

V. Phone/Fax

Practice location:
  • Phone: 609-248-0689
  • Fax:
Mailing address:
  • Phone: 609-248-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RACHEL ANNE CRESSE
Title or Position: OWNER
Credential: LCSW
Phone: 609-248-0689