Provider Demographics
NPI:1891026944
Name:CATHOLIC CHARITIES, DIOCESE OF TRENTON
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES, DIOCESE OF TRENTON
Other - Org Name:MONMOUTH COUNSELING PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-5181
Mailing Address - Street 1:100 MAIN ST
Mailing Address - Street 2:MONMOUTH COUNSELING PROGRAM
Mailing Address - City:KEANSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07734-1725
Mailing Address - Country:US
Mailing Address - Phone:609-394-3202
Mailing Address - Fax:609-278-6139
Practice Address - Street 1:100 MAIN ST
Practice Address - Street 2:MONMOUTH COUNSELING PROGRAM
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-1725
Practice Address - Country:US
Practice Address - Phone:609-394-3202
Practice Address - Fax:609-278-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0256552Medicaid