Provider Demographics
NPI:1295371243
Name:CORE COUNSELING OF NORTH JERSEY, LLC
Entity Type:Organization
Organization Name:CORE COUNSELING OF NORTH JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDDER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCADC
Authorized Official - Phone:201-875-5699
Mailing Address - Street 1:40 N VAN BRUNT ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2740
Mailing Address - Country:US
Mailing Address - Phone:201-875-5699
Mailing Address - Fax:201-503-2345
Practice Address - Street 1:40 N VAN BRUNT ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2740
Practice Address - Country:US
Practice Address - Phone:201-875-5699
Practice Address - Fax:201-503-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty