Healthcare Provider Details
I. General information
NPI: 1912869587
Provider Name (Legal Business Name): GRAND SLAM PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
32101 PALM CT
LAWRENCE TOWNSHIP NJ
08648-5200
US
IV. Provider business mailing address
32101 PALM CT BLDG 32
LAWRENCE TOWNSHIP NJ
08648-5200
US
V. Phone/Fax
- Phone: 856-607-2291
- Fax:
- Phone: 856-607-2291
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELEANOR
MCCABE
Title or Position: OWNER
Credential: PH.D.
Phone: 856-607-2291