Provider Demographics
NPI:1508025271
Name:HG COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:HG COUNSELING ASSOCIATES LLC
Other - Org Name:HG COUNSELING ASSOCIATES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MENTAL HEALTH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUTCHINSON-GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW, RPT
Authorized Official - Phone:856-266-2394
Mailing Address - Street 1:1 N MAIN ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2445
Mailing Address - Country:US
Mailing Address - Phone:856-266-2394
Mailing Address - Fax:609-654-0492
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2172
Practice Address - Country:US
Practice Address - Phone:856-266-2394
Practice Address - Fax:609-654-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051960001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty