Healthcare Provider Details

I. General information

NPI: 1558824821
Provider Name (Legal Business Name): ESSENTIAL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 POST RD STE M3
OAKLAND NJ
07436-1615
US

IV. Provider business mailing address

52 GOULD RD
NEWFOUNDLAND NJ
07435-1703
US

V. Phone/Fax

Practice location:
  • Phone: 201-259-3098
  • Fax:
Mailing address:
  • Phone: 201-259-3098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY CONWAY
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC, NCC
Phone: 201-259-3098