Provider Demographics
NPI:1710337225
Name:ANCHORED HOPE COUNSELING CENTER
Entity Type:Organization
Organization Name:ANCHORED HOPE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSW
Authorized Official - Phone:908-546-1520
Mailing Address - Street 1:1000 RTE 34 STE 205
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3477
Mailing Address - Country:US
Mailing Address - Phone:908-546-1520
Mailing Address - Fax:
Practice Address - Street 1:42 CRAIG ST
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1625
Practice Address - Country:US
Practice Address - Phone:732-977-9034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056812001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty