Provider Demographics
NPI:1356972657
Name:COUNSELING IN COMFORT THERAPEUTIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:COUNSELING IN COMFORT THERAPEUTIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-337-0641
Mailing Address - Street 1:63 RAYMOND PL
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2309
Mailing Address - Country:US
Mailing Address - Phone:908-337-0641
Mailing Address - Fax:973-433-7850
Practice Address - Street 1:63 RAYMOND PL
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2309
Practice Address - Country:US
Practice Address - Phone:908-337-0641
Practice Address - Fax:973-433-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508222456OtherNPI