Provider Demographics
NPI:1619373834
Name:COUPLES THERAPY SERVICES
Entity Type:Organization
Organization Name:COUPLES THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-804-4314
Mailing Address - Street 1:168 FRANKLIN CORNER RD STE B210
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2529
Mailing Address - Country:US
Mailing Address - Phone:732-804-4314
Mailing Address - Fax:
Practice Address - Street 1:180 TULIP LN
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4097
Practice Address - Country:US
Practice Address - Phone:732-804-4314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIANNA HABER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-16
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055223001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty