MEDICARE: COUNSELING SERVICES INCORPORATED

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	1041C0700X	Clinical Social Worker	070397-1	NY

General Provider Information

NPI Number	:	1780841577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING SERVICES INCORPORATED

Provider Business Mailing Address
First Line	:	555 NORTH AVE
Second Line	:	SUITE 23P
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2404
Country	:	US
Telephone Number	:	201-363-8840
Fax Number	:	201-363-8748

Provider Business Practice Location Address
First Line	:	555 NORTH AVE
Second Line	:	SUITE 23P
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2404
Country	:	US
Telephone Number	:	201-363-8840
Fax Number	:	201-363-8748

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LORIE ANN MEISELMAN
Credential	:	LCSW
Telephone Number	:	201-363-8840

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	05/20/2008

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