Provider Demographics
NPI:1922733286
Name:REBUILDING U COUNSELING LLC
Entity Type:Organization
Organization Name:REBUILDING U COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FABRIAN
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-397-9187
Mailing Address - Street 1:1 POND VIEW DR APT E2
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-5607
Mailing Address - Country:US
Mailing Address - Phone:856-397-9187
Mailing Address - Fax:
Practice Address - Street 1:1 POND VIEW DR APT E2
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-5607
Practice Address - Country:US
Practice Address - Phone:856-397-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty