Healthcare Provider Details

I. General information

NPI: 1942986716
Provider Name (Legal Business Name): JPS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 RTE 130 N. SUITE #6
WILLINGBORO NJ
08046-1415
US

IV. Provider business mailing address

4202 RTE 130 N. SUITE #6
WILLINGBORO NJ
08046-1415
US

V. Phone/Fax

Practice location:
  • Phone: 609-546-4572
  • Fax: 609-531-2240
Mailing address:
  • Phone: 609-546-4572
  • Fax: 609-531-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE HAYMAN
Title or Position: CLINICIAL DIRECTOR
Credential: LCSW
Phone: 609-444-9109