1548793102 NPI number — ASPIRE TO ACHIEVE COUNSELING SERVICES, LLC

Table of content: (NPI 1548793102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548793102 NPI number — ASPIRE TO ACHIEVE COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRE TO ACHIEVE COUNSELING SERVICES, 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:
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:
1548793102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 HIGHLAND AVE STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HADDON TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08108-2634
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-254-0828
Provider Business Mailing Address Fax Number:
856-854-0992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 HIGHLAND AVE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HADDON TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08108-2634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-254-0828
Provider Business Practice Location Address Fax Number:
856-254-0828
Provider Enumeration Date:
04/10/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BRITT-MEADOWS
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
EXEC. DIR./OWNER/SOLE MEMBER
Authorized Official Telephone Number:
856-254-0828

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  44SC0445536200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 305S00000X , with the licence number: 44SC0445536200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 424681ZHYF . This is a "82551 ENROLLMENT TYPE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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