Provider Demographics
NPI:1306384201
Name:GO BEYOND COUNSELING, LLC
Entity Type:Organization
Organization Name:GO BEYOND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-857-2095
Mailing Address - Street 1:1310 ROUTE 539
Mailing Address - Street 2:SUITE 18
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-9806
Mailing Address - Country:US
Mailing Address - Phone:609-857-2095
Mailing Address - Fax:
Practice Address - Street 1:1310 ROUTE 539
Practice Address - Street 2:SUITE 18
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-9806
Practice Address - Country:US
Practice Address - Phone:609-857-2095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00532900101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty