Provider Demographics
NPI:1760091342
Name:COUNSELING AND THERAPY CENTER LLC
Entity Type:Organization
Organization Name:COUNSELING AND THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW,LADCI, CADCII
Authorized Official - Phone:201-253-8012
Mailing Address - Street 1:128 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364-1729
Mailing Address - Country:US
Mailing Address - Phone:201-253-8012
Mailing Address - Fax:
Practice Address - Street 1:128 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-1729
Practice Address - Country:US
Practice Address - Phone:201-253-8012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty