Provider Demographics
NPI:1043804131
Name:MANASQUAN COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:MANASQUAN COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SONORA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-612-8635
Mailing Address - Street 1:38 TAYLOR AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3047
Mailing Address - Country:US
Mailing Address - Phone:732-612-8635
Mailing Address - Fax:732-223-8004
Practice Address - Street 1:38 TAYLOR AVE STE 1
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3047
Practice Address - Country:US
Practice Address - Phone:732-612-8635
Practice Address - Fax:732-223-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366850141OtherNPI
NJ1366850141OtherNPI