Provider Demographics
NPI:1669914040
Name:OCEAN WINDS COUNSELING SERVICE, LLC
Entity type:Organization
Organization Name:OCEAN WINDS COUNSELING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:MAIORANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:856-232-9222
Mailing Address - Street 1:141 S BLACK HORSE PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2975
Mailing Address - Country:US
Mailing Address - Phone:856-232-9222
Mailing Address - Fax:888-670-9877
Practice Address - Street 1:141 S BLACK HORSE PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2975
Practice Address - Country:US
Practice Address - Phone:856-232-9222
Practice Address - Fax:888-670-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO13356001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty