Provider Demographics
NPI:1922203322
Name:HUBER, PHILIP MICHAEL (LPC, ACS, LCADC)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:MICHAEL
Last Name:HUBER
Suffix:
Gender:M
Credentials:LPC, ACS, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 DELSEA DR # 1145
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-2266
Mailing Address - Country:US
Mailing Address - Phone:856-506-9084
Mailing Address - Fax:
Practice Address - Street 1:1170 DELSEA DR # 1145
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093-2266
Practice Address - Country:US
Practice Address - Phone:856-506-9084
Practice Address - Fax:856-853-0919
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00298700101YP2500X
PAPC002708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional