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General NPI Number Information
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NPI Number | 1558753079
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Entity Type | Organization
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Legal Business Name | MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 1215 LIVINGSTON AVE STE 7
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-3840
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Country | US
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Telephone | 732-317-1902
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Fax | 732-317-1903
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Provider Business Mailing Address
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Address Line | 1215 LIVINGSTON AVE STE 7
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-3840
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Country | US
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Telephone | 732-317-1902
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Fax | 732-317-1903
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. GODFRIED BANING
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Credential | PSY.D ; PH.D, LPC
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Telephone | 732-317-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC00358500
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License Number State | NJ
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