Provider Demographics
NPI:1851088488
Name:ANDREACH COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:ANDREACH COUNSELING GROUP LLC
Other - Org Name:JASON ANDREACH LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDREACH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-701-9363
Mailing Address - Street 1:2704 SHADY GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4245
Mailing Address - Country:US
Mailing Address - Phone:732-701-9363
Mailing Address - Fax:
Practice Address - Street 1:302 HAWTHORNE AVE STE 6
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-2539
Practice Address - Country:US
Practice Address - Phone:732-903-7012
Practice Address - Fax:732-903-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty