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General NPI Number Information
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NPI Number | 1245685080
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Entity Type | Organization
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Legal Business Name | TRUCARE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 11/28/2019
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Provider Practice Location Address
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Address Line | 788 SHREWSBURY AVE STE 2200
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City | TINTON FALLS
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State | NJ
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Zip | 07724-3080
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Country | US
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Telephone | 732-832-5411
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Fax | 848-300-2129
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Provider Business Mailing Address
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Address Line | 153 GRAND AVE APT 37
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-1446
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Country | US
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Telephone | 732-832-5411
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Fax | 848-300-2129
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Authorized Official
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Title or Position | OWNER/SOCIAL WORKER
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Name | MS. MICHELE MANCUSO
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Credential | LCSW
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Telephone | 732-832-5411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05550000
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License Number State | NJ
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