Provider Demographics
NPI:1144760588
Name:S NOVAK COUNSELING, LLC
Entity Type:Organization
Organization Name:S NOVAK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-491-9820
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:SUITE 4D
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-491-9820
Mailing Address - Fax:
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:SUITE 4D
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-491-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053762001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty