Healthcare Provider Details

I. General information

NPI: 1437109311
Provider Name (Legal Business Name): GENERATIONS COUNSELING & CARE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 W PASSAIC ST 2ND FLOOR
ROCHELLE PARK NJ
07662-3027
US

IV. Provider business mailing address

336 W PASSAIC ST 2ND FLOOR
ROCHELLE PARK NJ
07662-3027
US

V. Phone/Fax

Practice location:
  • Phone: 201-845-7030
  • Fax: 201-845-0899
Mailing address:
  • Phone: 201-845-7030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. VICKI S DOUECK
Title or Position: PRESIDENT/CEO
Credential: LCSW
Phone: 201-845-7030