Provider Demographics
NPI:1275956070
Name:JC COUNSELING & CONSULTING PC
Entity Type:Organization
Organization Name:JC COUNSELING & CONSULTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CREPSAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-797-9977
Mailing Address - Street 1:514 51ST AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5879
Mailing Address - Country:US
Mailing Address - Phone:626-797-9977
Mailing Address - Fax:626-844-2977
Practice Address - Street 1:514 51ST AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5879
Practice Address - Country:US
Practice Address - Phone:626-797-9977
Practice Address - Fax:626-844-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty