Healthcare Provider Details

I. General information

NPI: 1932961414
Provider Name (Legal Business Name): AAA COUNSELING & CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 PARK AVE STE 1
PLAINFIELD NJ
07060-3001
US

IV. Provider business mailing address

935 PARK AVE STE 1
PLAINFIELD NJ
07060-3001
US

V. Phone/Fax

Practice location:
  • Phone: 908-312-3232
  • Fax:
Mailing address:
  • Phone: 908-312-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: AUGUSTINE DOUGLAS
Title or Position: AGENCY PRINCIPAL
Credential: LCSW
Phone: 908-418-6938