Provider Demographics
NPI:1679161079
Name:TRACE INSTITUTE OF COUNSELING
Entity Type:Organization
Organization Name:TRACE INSTITUTE OF COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-468-4683
Mailing Address - Street 1:531 CHERRY ST APT C7
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1878
Mailing Address - Country:US
Mailing Address - Phone:908-468-4683
Mailing Address - Fax:866-656-1205
Practice Address - Street 1:29 EVANS PLACE
Practice Address - Street 2:SECOND FLR. SUITE 2
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444
Practice Address - Country:US
Practice Address - Phone:973-400-9702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IN CHRIST FELLOWSHIP MINISTRIES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No282J00000XHospitalsReligious Nonmedical Health Care InstitutionGroup - Single Specialty