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General NPI Number Information
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NPI Number | 1689578718
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Entity Type | Organization
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Legal Business Name | COCREATE HEALING CENTER, LLC
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 971 US HIGHWAY 202 N STE N
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City | BRANCHBURG
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State | NJ
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Zip | 08876-3757
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Country | US
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Telephone | 732-838-9927
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Fax | 732-605-5964
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Provider Business Mailing Address
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Address Line | 971 US HIGHWAY 202 N STE N
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City | BRANCHBURG
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State | NJ
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Zip | 08876-3757
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Country | US
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Telephone | 732-838-9927
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Fax | 732-605-5964
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Authorized Official
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Title or Position | OWNER/LPC
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Name | SAMANTHA GRIMALDI
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Credential | LPC
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Telephone | 732-838-9927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | NULL
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