Provider Demographics
NPI:1447570023
Name:THE COUNSELING AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:THE COUNSELING AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ECONOMOU
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:732-822-3242
Mailing Address - Street 1:466 MONMOUTH ST
Mailing Address - Street 2:SUITE 4L
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 DUNDAR RD
Practice Address - Street 2:SUITE 212
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3553
Practice Address - Country:US
Practice Address - Phone:201-292-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00408200101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty