Provider Demographics
NPI:1407530678
Name:PROGRESSIVE HEALING COUNSELING & CONSULTING SERVICES
Entity Type:Organization
Organization Name:PROGRESSIVE HEALING COUNSELING & CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMGBADE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-658-3939
Mailing Address - Street 1:14 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2535
Mailing Address - Country:US
Mailing Address - Phone:609-658-3939
Mailing Address - Fax:
Practice Address - Street 1:14 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2535
Practice Address - Country:US
Practice Address - Phone:609-658-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty