Provider Demographics
NPI:1871828525
Name:KNIC COUNSELING & CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:KNIC COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOISEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-503-7377
Mailing Address - Street 1:195 N HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2429
Mailing Address - Country:US
Mailing Address - Phone:609-503-7377
Mailing Address - Fax:609-358-0223
Practice Address - Street 1:2145 NOTTINGHAM WAY STE A
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3031
Practice Address - Country:US
Practice Address - Phone:609-503-7377
Practice Address - Fax:609-358-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00389100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health