Provider Demographics
NPI:1003163452
Name:ANDREACH & PAULSEN COUNSELING GROUP
Entity Type:Organization
Organization Name:ANDREACH & PAULSEN COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ANDREACH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-701-9363
Mailing Address - Street 1:2424 BRIDGE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4335
Mailing Address - Country:US
Mailing Address - Phone:732-903-7012
Mailing Address - Fax:732-903-7135
Practice Address - Street 1:2424 BRIDGE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4335
Practice Address - Country:US
Practice Address - Phone:732-903-7012
Practice Address - Fax:732-903-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045715001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty