Healthcare Provider Details
I. General information
NPI: 1740554062
Provider Name (Legal Business Name): COUNSELING & THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2012
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
466 KINDERKAMACK RD
ORADELL NJ
07649-1536
US
IV. Provider business mailing address
130 WHITMAN ST
HAWORTH NJ
07641-1947
US
V. Phone/Fax
- Phone: 201-663-2649
- Fax:
- Phone: 201-663-2649
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 44SC05483300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | 595212 |
| License Number State | NJ |
VIII. Authorized Official
Name:
SUZANNE
CALGI
Title or Position: MANAGER
Credential: LCSW
Phone: 201-663-2649