Provider Demographics
NPI:1083953574
Name:HOLISTIC COUNSELING SERVICES
Entity Type:Organization
Organization Name:HOLISTIC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAUNJENETTE
Authorized Official - Middle Name:ANTREASE
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MTS, MSW, LCSW
Authorized Official - Phone:856-318-1581
Mailing Address - Street 1:4101 ROUTE 42
Mailing Address - Street 2:SUITE B
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1782
Mailing Address - Country:US
Mailing Address - Phone:856-318-1581
Mailing Address - Fax:856-318-1583
Practice Address - Street 1:4101 ROUTE 42
Practice Address - Street 2:SUITE B
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1782
Practice Address - Country:US
Practice Address - Phone:856-318-1581
Practice Address - Fax:856-318-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055337001041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty