Provider Demographics
NPI:1033790647
Name:ELIZABETH GREENBURG COUNSELOR LLC
Entity Type:Organization
Organization Name:ELIZABETH GREENBURG COUNSELOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-420-6931
Mailing Address - Street 1:14 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5208
Mailing Address - Country:US
Mailing Address - Phone:973-420-6931
Mailing Address - Fax:973-420-6931
Practice Address - Street 1:14 FOREST AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5208
Practice Address - Country:US
Practice Address - Phone:973-420-6931
Practice Address - Fax:973-420-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty