Healthcare Provider Details

I. General information

NPI: 1437879905
Provider Name (Legal Business Name): BRIGHT FUTURES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 09/02/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 ROUTE 18 SOUTH SUITE 3000, SOUTH WING
EAST BRUNSWICK NJ
08816
US

IV. Provider business mailing address

PO BOX 717
SOUTH RIVER NJ
08882-0717
US

V. Phone/Fax

Practice location:
  • Phone: 732-570-2507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: THOMAS BERGEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 732-710-6319