Provider Demographics
NPI:1114159175
Name:FAMILY COUNSELING CENTER OF CLOSTER NJ INC.
Entity Type:Organization
Organization Name:FAMILY COUNSELING CENTER OF CLOSTER NJ INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ULRICH
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLUMBUS
Authorized Official - Suffix:
Authorized Official - Credentials:D MIN, LMFT
Authorized Official - Phone:201-768-3999
Mailing Address - Street 1:HARRINGTON AVENUE AND WEST STREET
Mailing Address - Street 2:BOX 547
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624
Mailing Address - Country:US
Mailing Address - Phone:201-768-3999
Mailing Address - Fax:
Practice Address - Street 1:HARRINGTON AVENUE AND WEST STREET
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624
Practice Address - Country:US
Practice Address - Phone:201-768-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00071800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health