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General NPI Number Information
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NPI Number | 1275418253
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Entity Type | Organization
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Legal Business Name | THE COUNSELING CENTER OF KEYPORT
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 328 MAPLE PL
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City | KEYPORT
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State | NJ
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Zip | 07735-1121
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Country | US
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Telephone | 732-217-1283
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CORONET AVE
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City | LINCROFT
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State | NJ
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Zip | 07738-1703
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Country | US
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Telephone | 845-709-0700
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MOLLY HAHN
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Credential | LCSW
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Telephone | 845-709-0700
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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 |
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License Number State |
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