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General NPI Number Information
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NPI Number | 1225341092
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Entity Type | Organization
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Legal Business Name | APPLE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 259 DELSEA DR
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City | SEWELL
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State | NJ
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Zip | 08080-9401
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Country | US
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Telephone | 856-881-1666
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Fax | 856-881-3339
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Provider Business Mailing Address
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Address Line | 259 DELSEA DR
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City | SEWELL
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State | NJ
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Zip | 08080-9401
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Country | US
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Telephone | 856-881-1666
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Fax | 856-881-3339
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. WARREN STEVEN WALLACE
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Credential | ED.D, LPC
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Telephone | 856-881-1666
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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 | 37PC00165300
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License Number State | NJ
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