=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659870012
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AFT COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2018
-----------------------------------------------------
Last Update Date | 02/12/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 COLUMBIA TPKE
-----------------------------------------------------
City | FLORHAM PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07932-2113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-370-5858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 MORRIS AVE
-----------------------------------------------------
City | SOUTH PLAINFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07080-4746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-217-7949
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | ARIELLE TREICH
-----------------------------------------------------
Credential | MA, LPC
-----------------------------------------------------
Telephone | 908-217-7949
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 37PC00615700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------