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General NPI Number Information
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NPI Number | 1871813469
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER AT HAMILTON, LLC
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 2667 NOTTINGHAM WAY STE 3
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City | HAMILTON
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State | NJ
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Zip | 08619-4116
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Country | US
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Telephone | 609-890-9998
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Fax | 609-890-9998
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Provider Business Mailing Address
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Address Line | 2667 NOTTINGHAM WAY STE 3
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City | HAMILTON
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State | NJ
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Zip | 08619-4116
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Country | US
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Telephone | 609-890-9998
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Fax | 609-890-9998
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Authorized Official
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Title or Position | DIRECTOR/ THERAPIST
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Name | MRS. JOANNA O'NEILL
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Credential | MA. LPC. NCC.
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Telephone | 609-890-9998
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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 | 44SC00289900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW-011397-L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00017900
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License Number State | NJ
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