Provider Demographics
NPI:1205583366
Name:EAC COUNSELING
Entity type:Organization
Organization Name:EAC COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELLUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROOMES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC, NCC, ACS
Authorized Official - Phone:973-310-6337
Mailing Address - Street 1:403 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1969
Mailing Address - Country:US
Mailing Address - Phone:973-310-6337
Mailing Address - Fax:
Practice Address - Street 1:403 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1969
Practice Address - Country:US
Practice Address - Phone:973-310-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty