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General NPI Number Information
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NPI Number | 1144435561
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Entity Type | Organization
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Legal Business Name | PREMIER COUNSELING & CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 302 RIVENDELL WAY
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City | EDISON
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State | NJ
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Zip | 08817-2008
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Country | US
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Telephone | 732-579-3477
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Fax |
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Provider Business Mailing Address
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Address Line | 302 RIVENDELL WAY
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City | EDISON
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State | NJ
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Zip | 08817-2008
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Country | US
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Telephone | 732-579-3477
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. HASAN JOHNSON
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Credential | MSW, LCSW
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Telephone | 732-579-3477
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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 |
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License Number State |
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