1922162296 NPI number — REGIONAL COUNSELING SERVICES OF SOUTHERN NEW JERSEY

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 1922162296 NPI number — REGIONAL COUNSELING SERVICES OF SOUTHERN NEW JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL COUNSELING SERVICES OF SOUTHERN NEW JERSEY
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:
1922162296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LAUREL OAK CORPORATE CENTER
Provider Second Line Business Mailing Address:
1000 HADDONFIELD-BERLIN ROAD, SUITE 207
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-784-1001
Provider Business Mailing Address Fax Number:
856-784-5115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LAUREL OAK CORPORATE CENTER
Provider Second Line Business Practice Location Address:
1000 HADDONFIELD-BERLIN ROAD, SUITE 207
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-784-1001
Provider Business Practice Location Address Fax Number:
856-784-5115
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
TRACEY
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
856-784-1001

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , 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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