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General NPI Number Information
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NPI Number | 1669914040
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Entity Type | Organization
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Legal Business Name | OCEAN WINDS COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 141 S BLACK HORSE PIKE SUITE 101
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City | BLACKWOOD
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State | NJ
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Zip | 08012-2975
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Country | US
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Telephone | 856-232-9222
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Fax | 888-670-9877
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Provider Business Mailing Address
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Address Line | 141 S BLACK HORSE PIKE SUITE 101
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City | BLACKWOOD
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State | NJ
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Zip | 08012-2975
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Country | US
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Telephone | 856-232-9222
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Fax | 888-670-9877
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Authorized Official
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Title or Position | MANAGING MEMBER/SOCIAL WORKER
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Name | MR. MICHAEL LOUIS MAIORANO
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Credential | MSW, LCSW
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Telephone | 856-232-9222
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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 | 44SCO1335600
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License Number State | NJ
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