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General NPI Number Information
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NPI Number | 1912182098
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Entity Type | Organization
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Legal Business Name | CDR COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 1000 HERRONTOWN RD
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City | PRINCETON
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State | NJ
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Zip | 08540-7716
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Country | US
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Telephone | 732-398-1718
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Fax |
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Provider Business Mailing Address
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Address Line | 6 RALEIGH WAY
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City | FRANKLIN PARK
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State | NJ
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Zip | 08823-1700
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Country | US
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Telephone | 732-398-1718
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/SOLE MEMBER
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Name | PROF. CHRISTINA D REEG
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Credential | LCSW
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Telephone | 732-398-1718
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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 | 44SC05177900
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License Number State | NJ
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