Provider Demographics
NPI:1700649894
Name:THE COUNSELING CENTER GROUP, LLC
Entity Type:Organization
Organization Name:THE COUNSELING CENTER GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO & CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUGARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-519-8010
Mailing Address - Street 1:48 TRAFFORD ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4024
Mailing Address - Country:US
Mailing Address - Phone:973-600-1626
Mailing Address - Fax:
Practice Address - Street 1:65 MECHANIC ST STE L-2
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1852
Practice Address - Country:US
Practice Address - Phone:888-572-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty