1386695070 NPI number — THE NEW CENTER FOR COUNSELING AND PSYCHOTHERAPY, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386695070 NPI number — THE NEW CENTER FOR COUNSELING AND PSYCHOTHERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE NEW CENTER FOR COUNSELING AND PSYCHOTHERAPY, LLC
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:
6
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:
1386695070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
152 BRIGANTINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANAHAWKIN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08050-1308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-494-0009
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
816 LONG BEACH BLVD
Provider Second Line Business Practice Location Address:
SECOND FLOOR, UNIT 3
Provider Business Practice Location Address City Name:
SHIP BOTTOM
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08008-4608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-494-0009
Provider Business Practice Location Address Fax Number:
609-660-2275
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GIBBONS
Authorized Official First Name:
DON
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
609-494-0009

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  35S100351300 , 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)





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