Provider Demographics
NPI:1265698278
Name:GREATER ESSEX COUNSELING SERVICES
Entity type:Organization
Organization Name:GREATER ESSEX COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARDUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-623-7878
Mailing Address - Street 1:30 CLINTON ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3726
Mailing Address - Country:US
Mailing Address - Phone:973-623-7878
Mailing Address - Fax:973-623-6536
Practice Address - Street 1:30 CLINTON ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3726
Practice Address - Country:US
Practice Address - Phone:973-623-7878
Practice Address - Fax:973-623-6536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED LABOR AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20000289251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ101676OtherNEW JERSEY SAMS
NJ0165328Medicaid
NJ2000289OtherNEW JERSEY LICENSE DIVISION OF ADDICTION SERVICES