Healthcare Provider Details

I. General information

NPI: 1386210466
Provider Name (Legal Business Name): ORANGE SUN COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2021
Last Update Date: 01/23/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 SHERWOOD RD
MAYS LANDING NJ
08330-9505
US

IV. Provider business mailing address

#1034 300 WRANGLEBORO RD STE 120
MAYS LANDING NJ
08330
US

V. Phone/Fax

Practice location:
  • Phone: 732-443-0658
  • Fax:
Mailing address:
  • Phone: 732-443-0658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER WILLIAM CANTWELL
Title or Position: FOUNDER / COUNSELOR
Credential: LPC
Phone: 732-443-0658