Provider Demographics
NPI:1033548847
Name:COUNSELING CENTER FOR GROWTH AND DEVELOPMENT
Entity Type:Organization
Organization Name:COUNSELING CENTER FOR GROWTH AND DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HESSLER
Authorized Official - Suffix:SR
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:908-591-2271
Mailing Address - Street 1:92 BROADWAY STE 104
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2733
Mailing Address - Country:US
Mailing Address - Phone:908-591-2271
Mailing Address - Fax:
Practice Address - Street 1:92 BROADWAY STE 104
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2733
Practice Address - Country:US
Practice Address - Phone:908-591-2271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00379600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health