Provider Demographics
NPI:1093131336
Name:ESV
Entity Type:Organization
Organization Name:ESV
Other - Org Name:MARKELL COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC, CEAP
Authorized Official - Phone:732-817-0103
Mailing Address - Street 1:1118 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1261
Mailing Address - Country:US
Mailing Address - Phone:732-817-0103
Mailing Address - Fax:732-817-0105
Practice Address - Street 1:25 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1259
Practice Address - Country:US
Practice Address - Phone:732-257-6662
Practice Address - Fax:732-257-5647
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTER SEASL NEW JERSEY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-11
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00041500101YA0400X
NJ37PC00347400101YP2500X
NJ44SC049369001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty