Provider Demographics
NPI:1558753079
Name:MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:MULTIFAITH AND MULTICULTURAL COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GODFRIED
Authorized Official - Middle Name:
Authorized Official - Last Name:BANING
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD ; PHD, LPC
Authorized Official - Phone:732-317-1902
Mailing Address - Street 1:1215 LIVINGSTON AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3840
Mailing Address - Country:US
Mailing Address - Phone:732-317-1902
Mailing Address - Fax:732-317-1903
Practice Address - Street 1:1215 LIVINGSTON AVE STE 7
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3840
Practice Address - Country:US
Practice Address - Phone:732-317-1902
Practice Address - Fax:732-317-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00358500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty