Provider Demographics
NPI:1235521139
Name:ESSEX COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:ESSEX COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LODATO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-295-0999
Mailing Address - Street 1:206 MAIN ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1158
Mailing Address - Country:US
Mailing Address - Phone:973-295-0999
Mailing Address - Fax:
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:SUITE 22
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1158
Practice Address - Country:US
Practice Address - Phone:973-295-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054629001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty