Provider Demographics
NPI:1033213251
Name:NEUROPSYCHOLOGY & COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY & COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BATLAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-840-5266
Mailing Address - Street 1:1683 ROUTE 88
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3050
Mailing Address - Country:US
Mailing Address - Phone:732-840-5266
Mailing Address - Fax:732-840-7840
Practice Address - Street 1:1683 ROUTE 88
Practice Address - Street 2:SUITE A
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3050
Practice Address - Country:US
Practice Address - Phone:732-840-5266
Practice Address - Fax:732-840-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101Y00000X, 103G00000X, 103T00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ055953QEKMedicare PIN