Provider Demographics
NPI:1396496774
Name:JEFFREY THOELEN COUNSELING LLC
Entity type:Organization
Organization Name:JEFFREY THOELEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOELEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-229-4976
Mailing Address - Street 1:16 LEDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9428
Mailing Address - Country:US
Mailing Address - Phone:973-229-4976
Mailing Address - Fax:
Practice Address - Street 1:16 LEDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9428
Practice Address - Country:US
Practice Address - Phone:973-229-4976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty