Provider Demographics
NPI:1083755722
Name:COUNSELING AND DEVELOPMENT GROUP, PA
Entity Type:Organization
Organization Name:COUNSELING AND DEVELOPMENT GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-714-1830
Mailing Address - Street 1:516 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2554
Mailing Address - Country:US
Mailing Address - Phone:732-714-1830
Mailing Address - Fax:732-714-7842
Practice Address - Street 1:516 BAY AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-2554
Practice Address - Country:US
Practice Address - Phone:732-714-1830
Practice Address - Fax:732-714-7842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052033001041C0700X
NJ44SC045076001041C0700X
NJ44SC005239001041C0700X
NJ44SC001359001041C0700X
NYR034438-11041C0700X
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ10764796OtherCAQH
NJ166336OtherVALUE OPTIONS
NJ83720OtherCIGNA
NJ246724OtherMHN
NJ2179128000OtherAMERIHEALTH
NJP1967658OtherOXFORD