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General NPI Number Information
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NPI Number | 1023457645
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH SERVICES OF NEW JERSEY, LLC
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 08/24/2013
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Provider Practice Location Address
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Address Line | 1 CRABAPPLE LN
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City | FRANKLIN PARK
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State | NJ
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Zip | 08823-1406
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Country | US
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Telephone | 908-463-9665
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Fax |
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Provider Business Mailing Address
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Address Line | 30 KNIGHTSBRIDGE RD SUITE 525
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3948
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Country | US
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Telephone | 908-463-9665
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. STACEY ANN STABACK
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Credential | LPC
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Telephone | 908-463-9665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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