Provider Demographics
NPI:1841771474
Name:TEAMUP COUNSELING, LLC
Entity Type:Organization
Organization Name:TEAMUP COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAWLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-292-3475
Mailing Address - Street 1:229 DIVISION ST APT C
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2331
Mailing Address - Country:US
Mailing Address - Phone:201-725-3613
Mailing Address - Fax:201-328-9404
Practice Address - Street 1:632 BERGEN BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-2021
Practice Address - Country:US
Practice Address - Phone:201-917-3226
Practice Address - Fax:201-328-9404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEAMUP COUNSELING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0504203Medicaid