Provider Demographics
NPI:1336852185
Name:COVERED BRIDGE COUNSELING FOR RELATIONSHIPS LLC
Entity Type:Organization
Organization Name:COVERED BRIDGE COUNSELING FOR RELATIONSHIPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUSPAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:215-919-5172
Mailing Address - Street 1:204 WHITE HORSE PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1739
Mailing Address - Country:US
Mailing Address - Phone:215-919-5172
Mailing Address - Fax:
Practice Address - Street 1:204 WHITE HORSE PIKE STE A
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1739
Practice Address - Country:US
Practice Address - Phone:215-919-5172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty