Healthcare Provider Details

I. General information

NPI: 1801919469
Provider Name (Legal Business Name): ODYSSEY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 MARLTON PIKE E SUITE N70
CHERRY HILL NJ
08003-2150
US

IV. Provider business mailing address

1930 MARLTON PIKE E SUITE N70
CHERRY HILL NJ
08003-2150
US

V. Phone/Fax

Practice location:
  • Phone: 856-985-6300
  • Fax: 856-985-6424
Mailing address:
  • Phone: 856-985-6300
  • Fax: 856-985-6424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NC09079300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04407500
License Number StateNJ

VIII. Authorized Official

Name: AMY BRESLOW
Title or Position: PARTNER
Credential: MSW, LCSW
Phone: 856-985-6300