Provider Demographics
NPI:1710618681
Name:COMPREHENSIVE COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-674-9857
Mailing Address - Street 1:10 SHADY TER
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4320
Mailing Address - Country:US
Mailing Address - Phone:201-320-6334
Mailing Address - Fax:
Practice Address - Street 1:913 ROUTE 23 STE 206
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1300
Practice Address - Country:US
Practice Address - Phone:201-320-6334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1588078323OtherCOMMERCIAL