Provider Demographics
NPI:1508345257
Name:CONNECT COUNSELING & WELLNESS, LLC
Entity Type:Organization
Organization Name:CONNECT COUNSELING & WELLNESS, LLC
Other - Org Name:CONNECT COUNSELING & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:KIRA
Authorized Official - Last Name:MELONE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CBCS
Authorized Official - Phone:201-554-7315
Mailing Address - Street 1:155 COUNTY RD STE 14
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2200
Mailing Address - Country:US
Mailing Address - Phone:201-788-3122
Mailing Address - Fax:
Practice Address - Street 1:155 COUNTY RD STE 14
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-2200
Practice Address - Country:US
Practice Address - Phone:201-399-7225
Practice Address - Fax:855-615-8638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NJ44SC05436200261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1W1259OtherMEDICARE
NJ9246734OtherAETNA
NJ60525884OtherHORIZON NJ HEALTH
NJ1W1244OtherMEDICARE
NJ0856291Medicaid