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General NPI Number Information
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NPI Number | 1083953574
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Entity Type | Organization
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Legal Business Name | HOLISTIC COUNSELING SERVICES
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 4101 ROUTE 42 SUITE B
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1782
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Country | US
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Telephone | 856-318-1581
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Fax | 856-318-1583
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Provider Business Mailing Address
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Address Line | 4101 ROUTE 42 SUITE B
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1782
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Country | US
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Telephone | 856-318-1581
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Fax | 856-318-1583
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. TAUNJENETTE ANTREASE POOLE
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Credential | MTS, MSW, LCSW
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Telephone | 856-318-1581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44SC05533700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05533700
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License Number State | NJ
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