Provider Demographics
NPI:1235261090
Name:AFFINITY COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:AFFINITY COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PASSENTI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:973-427-7100
Mailing Address - Street 1:142 VALENCIA DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7013
Mailing Address - Country:US
Mailing Address - Phone:973-207-0303
Mailing Address - Fax:
Practice Address - Street 1:600 VALLEY RD STE 202
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3551
Practice Address - Country:US
Practice Address - Phone:973-427-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty