Healthcare Provider Details

I. General information

NPI: 1255286399
Provider Name (Legal Business Name): CUP OF TEA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 LACEY RD STE A
FORKED RIVER NJ
08731-1063
US

IV. Provider business mailing address

PO BOX 693
BAYVILLE NJ
08721-0693
US

V. Phone/Fax

Practice location:
  • Phone: 571-669-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELISSA STEVENS
Title or Position: OWNER
Credential: LPC
Phone: 571-669-3400