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General NPI Number Information
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NPI Number | 1881026151
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR COUNSELING AND HOLISTIC SERVICES
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 271 ROUTE 46 W C-110
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2440
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Country | US
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Telephone | 201-491-6060
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Fax | 201-346-4365
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Provider Business Mailing Address
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Address Line | 2410 2ND ST
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City | FORT LEE
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State | NJ
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Zip | 07024-4004
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Country | US
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Telephone | 201-491-6060
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Fax | 201-346-4365
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Authorized Official
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Title or Position | FOUNDING EXECUTIVE DIRECTOR
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Name | MRS. VASHONNA ETIENNE
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Credential | LCSW
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Telephone | 201-491-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 44SC05537800
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License Number State | NJ
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