Provider Demographics
NPI:1194841544
Name:SOPER, JOHN ROBERT JR (MA, NCC, LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:SOPER
Suffix:JR
Gender:M
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STATE ROUTE 33
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:MILLSTONE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08535-8538
Mailing Address - Country:US
Mailing Address - Phone:732-889-3089
Mailing Address - Fax:
Practice Address - Street 1:500 STATE ROUTE 33
Practice Address - Street 2:SUITE 2G
Practice Address - City:MILLSTONE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08535-8538
Practice Address - Country:US
Practice Address - Phone:732-889-3089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00041600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional