Provider Demographics
NPI:1821245739
Name:BB COUNSELING LLC
Entity Type:Organization
Organization Name:BB COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-539-3023
Mailing Address - Street 1:25 WINDINGBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2332
Mailing Address - Country:US
Mailing Address - Phone:732-539-3023
Mailing Address - Fax:732-876-9198
Practice Address - Street 1:119 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1715
Practice Address - Country:US
Practice Address - Phone:732-856-0671
Practice Address - Fax:732-876-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100440800103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty