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General NPI Number Information
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NPI Number | 1053805242
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Entity Type | Organization
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Legal Business Name | AUTHENTIC AWARENESS COUNSELING, LLC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 319 FARNSWORTH AVE
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1708
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Country | US
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Telephone | 609-379-6298
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Fax |
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Provider Business Mailing Address
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Address Line | 319 FARNSWORTH AVE
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1708
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Country | US
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Telephone | 609-379-6298
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM F BURNS-LYNCH
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Credential | MA, LPC
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Telephone | 609-379-6298
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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 | 37PC00468200
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License Number State | NJ
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