Healthcare Provider Details

I. General information

NPI: 1508340811
Provider Name (Legal Business Name): VISITING COUNSELOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 7TH ST
HAZLET TWP NJ
07734-2969
US

IV. Provider business mailing address

138 7TH ST
HAZLET TWP NJ
07734-2969
US

V. Phone/Fax

Practice location:
  • Phone: 908-419-2044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANTONIETTE RICHBURG
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 908-419-2044