MEDICARE: CCC COUNSELING THERAPEUTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1427800820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CCC COUNSELING THERAPEUTICS LLC

Provider Business Mailing Address
First Line	:	1212 TODD CT
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2256
Country	:	US
Telephone Number	:	609-225-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 ROUTE 34 STE 121B
Second Line	:
City	:	COLTS NECK
State	:	NJ
Zip	:	07722-2446
Country	:	US
Telephone Number	:	732-242-7393
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHULAMITH ABRAHAM
Credential	:
Telephone Number	:	732-242-7393

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	04/01/2024

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Directions to “CCC COUNSELING THERAPEUTICS LLC ” Practice Location

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