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General NPI Number Information
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NPI Number | 1679161079
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Entity Type | Organization
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Legal Business Name | TRACE INSTITUTE OF COUNSELING
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Dates
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Enumeration Date | 01/02/2021
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Last Update Date | 01/02/2021
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Provider Practice Location Address
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Address Line | 29 EVANS PLACE SECOND FLR. SUITE 2
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444
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Country | US
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Telephone | 973-400-9702
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Fax |
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Provider Business Mailing Address
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Address Line | 531 CHERRY ST APT C7
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City | ELIZABETH
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State | NJ
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Zip | 07208-1878
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Country | US
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Telephone | 908-468-4683
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Fax | 866-656-1205
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | WILLIAM HAMPTON
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Credential |
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Telephone | 908-468-4683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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