Provider Demographics
NPI:1366848582
Name:CCC COUNSELING INC
Entity Type:Organization
Organization Name:CCC COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEDIEDJAH
Authorized Official - Middle Name:MOSHE RODRIGUES
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCADC
Authorized Official - Phone:732-814-4648
Mailing Address - Street 1:1212 TODD CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2256
Mailing Address - Country:US
Mailing Address - Phone:732-814-4648
Mailing Address - Fax:609-228-8896
Practice Address - Street 1:1212 TODD CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2256
Practice Address - Country:US
Practice Address - Phone:609-225-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty