MEDICARE: MORRIS COUNTY COUNSELING SERVICES

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	101YP2500X	Professional Counselor	37PC00350300	NJ

General Provider Information

NPI Number	:	1518335496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORRIS COUNTY COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	95 W 13TH ST
Second Line	:	1ST FLR
City	:	BAYONNE
State	:	NJ
Zip	:	07002-1343
Country	:	US
Telephone Number	:	201-668-1001
Fax Number	:	201-510-0758

Provider Business Practice Location Address
First Line	:	147 COLUMBIA TPKE STE 307
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2145
Country	:	US
Telephone Number	:	201-668-1001
Fax Number	:	201-510-0758

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. BRIAN A NANDY
Credential	:	LPC
Telephone Number	:	908-219-9008

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	01/04/2019

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