Healthcare Provider Details

I. General information

NPI: 1487699336
Provider Name (Legal Business Name): CAPE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 CREST HAVEN RD
CAPE MAY COURT HOUSE NJ
08210-1651
US

IV. Provider business mailing address

1129 S ROUTE 9 SUITE 1
CAPE MAY COURT HOUSE NJ
08210-2752
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-4100
  • Fax: 609-465-2588
Mailing address:
  • Phone: 609-778-6103
  • Fax: 609-778-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number40401
License Number StateNJ

VIII. Authorized Official

Name: GREG SPEED
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW
Phone: 609-778-6101