Provider Demographics
NPI:1821706946
Name:TMC PROFESSIONAL COUNSELING SERVICE
Entity Type:Organization
Organization Name:TMC PROFESSIONAL COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:973-919-6698
Mailing Address - Street 1:1512B BONITO LN
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-5765
Mailing Address - Country:US
Mailing Address - Phone:973-919-6698
Mailing Address - Fax:
Practice Address - Street 1:2460 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428
Practice Address - Country:US
Practice Address - Phone:973-919-6698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty