Healthcare Provider Details

I. General information

NPI: 1912182098
Provider Name (Legal Business Name): CDR COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HERRONTOWN RD
PRINCETON NJ
08540-7716
US

IV. Provider business mailing address

6 RALEIGH WAY
FRANKLIN PARK NJ
08823-1700
US

V. Phone/Fax

Practice location:
  • Phone: 732-398-1718
  • Fax:
Mailing address:
  • Phone: 732-398-1718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05177900
License Number StateNJ

VIII. Authorized Official

Name: PROF. CHRISTINA D REEG
Title or Position: PSYCHOTHERAPIST/SOLE MEMBER
Credential: LCSW
Phone: 732-398-1718