Provider Demographics
NPI:1518011980
Name:SPINCIC HEALTH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SPINCIC HEALTH ASSOCIATES, INC.
Other - Org Name:BLOOMFIELD COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SPINAZZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:732-545-7678
Mailing Address - Street 1:39 CORONA RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1357
Mailing Address - Country:US
Mailing Address - Phone:732-545-7678
Mailing Address - Fax:732-545-0017
Practice Address - Street 1:39 CORONA RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1357
Practice Address - Country:US
Practice Address - Phone:732-545-7678
Practice Address - Fax:732-545-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJFI00937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty