Provider Demographics
NPI:1013305234
Name:CAPE COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:CAPE COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-778-6101
Mailing Address - Street 1:1129 S ROUTE 9
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2752
Mailing Address - Country:US
Mailing Address - Phone:609-778-6103
Mailing Address - Fax:609-778-6173
Practice Address - Street 1:128 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1651
Practice Address - Country:US
Practice Address - Phone:609-465-4100
Practice Address - Fax:609-465-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000306101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0429040Medicaid