Provider Demographics
NPI:1043451594
Name:COUNSELING CENTER FOR TRAUMA AND GRIEF A NJ NONPROFIT CORPORATION
Entity Type:Organization
Organization Name:COUNSELING CENTER FOR TRAUMA AND GRIEF A NJ NONPROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-834-1181
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-0316
Mailing Address - Country:US
Mailing Address - Phone:856-834-1181
Mailing Address - Fax:856-834-1183
Practice Address - Street 1:212 W ROUTE 38
Practice Address - Street 2:SUITE 200
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3238
Practice Address - Country:US
Practice Address - Phone:856-834-1181
Practice Address - Fax:856-834-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000319001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty