Provider Demographics
NPI: | 1346996212 |
---|---|
Name: | SPRING RAIN COUNSELING |
Entity Type: | Organization |
Organization Name: | SPRING RAIN COUNSELING |
Other - Org Name: | RENEE MOFFETT LCSW |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PSYCHOTHERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RENEE |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | MOFFETT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCSW, LCADC |
Authorized Official - Phone: | 732-290-5891 |
Mailing Address - Street 1: | 1515 STATE ROUTE 35 # 1013 |
Mailing Address - Street 2: | |
Mailing Address - City: | MIDDLETOWN |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07748-1829 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-290-5891 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1515 STATE ROUTE 35 # 1013 |
Practice Address - Street 2: | |
Practice Address - City: | MIDDLETOWN |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07748-1829 |
Practice Address - Country: | US |
Practice Address - Phone: | 732-707-5002 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-03-01 |
Last Update Date: | 2024-04-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |