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General NPI Number Information
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NPI Number | 1396970273
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Entity Type | Organization
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Legal Business Name | PRIME COUNSELING, LLC
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 187 WASHINGTON AVE STE 2C
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City | NUTLEY
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State | NJ
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Zip | 07110-3935
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Country | US
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Telephone | 862-201-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 441 DEWITT AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-2753
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Country | US
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Telephone | 862-201-9127
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | VICTOR M ALVAREZ
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Credential | LCSW
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Telephone | 862-201-9127
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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 | 44SC05263200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC0538300
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License Number State | NJ
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