Provider Demographics
NPI:1780045955
Name:EMPOWERMENT THROUGH SELF PSYCHOLOGICAL COUNSELING, LLC
Entity type:Organization
Organization Name:EMPOWERMENT THROUGH SELF PSYCHOLOGICAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:973-713-7055
Mailing Address - Street 1:58 BIG SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-9714
Mailing Address - Country:US
Mailing Address - Phone:973-713-7055
Mailing Address - Fax:973-209-4357
Practice Address - Street 1:58 BIG SPRING RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-9714
Practice Address - Country:US
Practice Address - Phone:973-713-7055
Practice Address - Fax:973-209-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherSELF