Provider Demographics
NPI:1205293180
Name:TEAMUP COUNSELING
Entity type:Organization
Organization Name:TEAMUP COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAWLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-725-3613
Mailing Address - Street 1:363 COLUMBIA AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1903
Mailing Address - Country:US
Mailing Address - Phone:201-725-3613
Mailing Address - Fax:201-328-9404
Practice Address - Street 1:363 COLUMBIA AVE
Practice Address - Street 2:UNIT C
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1903
Practice Address - Country:US
Practice Address - Phone:201-725-3613
Practice Address - Fax:201-328-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05312600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health