Provider Demographics
NPI:1225341092
Name:APPLE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:APPLE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC
Authorized Official - Phone:856-881-1666
Mailing Address - Street 1:259 DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9401
Mailing Address - Country:US
Mailing Address - Phone:856-881-1666
Mailing Address - Fax:856-881-3339
Practice Address - Street 1:259 DELSEA DR
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9401
Practice Address - Country:US
Practice Address - Phone:856-881-1666
Practice Address - Fax:856-881-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00165300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0161888Medicaid