Provider Demographics
NPI:1821851361
Name:TEAM COUNSELING
Entity Type:Organization
Organization Name:TEAM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC ACS
Authorized Official - Phone:732-673-4689
Mailing Address - Street 1:82 KEMP AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07704-3530
Mailing Address - Country:US
Mailing Address - Phone:732-673-4689
Mailing Address - Fax:
Practice Address - Street 1:82 KEMP AVE
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704-3530
Practice Address - Country:US
Practice Address - Phone:732-673-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)