Provider Demographics
NPI:1003457060
Name:SYMMETRY OF SELF COUNSELING CENTER
Entity Type:Organization
Organization Name:SYMMETRY OF SELF COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPAUL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-292-5700
Mailing Address - Street 1:195 BILLOWS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ROYAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08061-1073
Mailing Address - Country:US
Mailing Address - Phone:609-970-8142
Mailing Address - Fax:856-292-5717
Practice Address - Street 1:1167 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08051-1649
Practice Address - Country:US
Practice Address - Phone:856-292-5700
Practice Address - Fax:856-292-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty