Provider Demographics
NPI:1063842235
Name:PREMIER COUNSELING SERVICES
Entity Type:Organization
Organization Name:PREMIER COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOLLOY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-933-5766
Mailing Address - Street 1:87 MILLER ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-2209
Mailing Address - Country:US
Mailing Address - Phone:201-933-5766
Mailing Address - Fax:
Practice Address - Street 1:87 MILLER ST
Practice Address - Street 2:SUITE #1
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-2209
Practice Address - Country:US
Practice Address - Phone:201-933-5766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC047463001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty