Provider Demographics
NPI:1962863605
Name:EPIPHANY RELATIONSHIP AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:EPIPHANY RELATIONSHIP AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KADIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYNADO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-531-6905
Mailing Address - Street 1:120 W 7TH ST STE 215
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-1629
Mailing Address - Country:US
Mailing Address - Phone:908-531-6905
Mailing Address - Fax:
Practice Address - Street 1:120 W 7TH ST STE 215
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-1629
Practice Address - Country:US
Practice Address - Phone:908-531-6905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00440300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health