Provider Demographics
NPI:1952637779
Name:HARVEST COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:HARVEST COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ADA
Authorized Official - Last Name:CASSELBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:609-408-9488
Mailing Address - Street 1:126 N BARTRAM AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-3308
Mailing Address - Country:US
Mailing Address - Phone:609-266-2227
Mailing Address - Fax:609-266-2229
Practice Address - Street 1:4276 HARBOR BEACH BLVD
Practice Address - Street 2:D
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1363
Practice Address - Country:US
Practice Address - Phone:609-266-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000297-08261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder