Provider Demographics
NPI:1316559768
Name:SAND PATH COUNSELING LLC
Entity Type:Organization
Organization Name:SAND PATH COUNSELING LLC
Other - Org Name:SAND PATH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EDELHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-966-5195
Mailing Address - Street 1:PO BOX 1960
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-1960
Mailing Address - Country:US
Mailing Address - Phone:732-966-5195
Mailing Address - Fax:
Practice Address - Street 1:509 MAIN ST BLDG C
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7402
Practice Address - Country:US
Practice Address - Phone:732-503-9253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty