Provider Demographics
NPI:1114639655
Name:BREAKTHROUGH COUNSELING AND BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING AND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-353-6112
Mailing Address - Street 1:1 NALBONE CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9777
Mailing Address - Country:US
Mailing Address - Phone:609-353-6112
Mailing Address - Fax:
Practice Address - Street 1:1 NALBONE CT
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08620-9777
Practice Address - Country:US
Practice Address - Phone:609-353-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty