1750417838 NPI number — ADULTS& CHILDREN BEHAVIORAL COUNSELING

Table of content: (NPI 1750417838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750417838 NPI number — ADULTS& CHILDREN BEHAVIORAL COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADULTS& CHILDREN BEHAVIORAL COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750417838
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1926
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08724-3265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-701-0440
Provider Business Mailing Address Fax Number:
732-701-0419

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2095 ROUTE 88
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
BRICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08724-3265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-701-0440
Provider Business Practice Location Address Fax Number:
732-701-0419
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DELHAGEN
Authorized Official First Name:
EILEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
732-701-0440

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  44SC008454000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1972570216 . This is a "EILEEN DELHAGEN NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1932176963 . This is a "CAROLYN SCHLOBALM NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1093826943 . This is a "KIMBERLY HIGGINS NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1740258193 . This is a "JASON ANDREACH NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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