Provider Demographics
NPI:1659055382
Name:RESTORE & RESET COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:RESTORE & RESET COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:NICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:LBS, LPC
Authorized Official - Phone:201-484-6611
Mailing Address - Street 1:1256 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08104-3544
Mailing Address - Country:US
Mailing Address - Phone:201-484-6611
Mailing Address - Fax:
Practice Address - Street 1:6816 MARSDEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-2220
Practice Address - Country:US
Practice Address - Phone:201-484-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty