Provider Demographics
NPI:1326478157
Name:PARK ROAD CONSULTING LLC
Entity Type:Organization
Organization Name:PARK ROAD CONSULTING LLC
Other - Org Name:NA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:GERSHON
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:973-454-7405
Mailing Address - Street 1:2 PARK RD.
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-454-7405
Mailing Address - Fax:973-379-3008
Practice Address - Street 1:2 PARK RD.
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078
Practice Address - Country:US
Practice Address - Phone:973-454-7405
Practice Address - Fax:973-379-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty