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General NPI Number Information
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NPI Number | 1386192680
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Entity Type | Organization
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Legal Business Name | FAMILY VALUES COUNSELING LLC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 78 MERILINE AVE
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-3095
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Country | US
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Telephone | 973-202-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 40 N VAN BRUNT ST SUITE 21
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | SILVIA MARQUES-COSTEIRA
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Credential | MS LMFT LPC
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Telephone | 973-202-6580
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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 | 37PC00341200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37FI00173200
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License Number State | NJ
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