Organization · NPI-2

490 Counseling

Social Worker, Clinical · Eatontown, NJ

NPI number1962008250
StatusActive
Last updated in NPPESDec 10, 2020

Details

NPI
1962008250
Entity type
Organization (NPI-2)
Legal business name
490 Counseling
Organization subpart
No
Enumeration date
Dec 10, 2020
Certification date
Dec 10, 2020
Last updated
Dec 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes
101YM0800X Counselor, Mental Health––
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Practice location

48b Southbrook Dr
Eatontown, NJ 07724-1829

Phone 973-862-3111

Mailing address

48b Southbrook Dr
Eatontown, NJ 07724-1829

Phone 973-862-3111

Authorized official

Julianna Calleo
Ceo
9738623111

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