Provider Demographics
NPI:1881360022
Name:TRI-COUNTY COMMUNITY ACTION AGENCY, INC.
Entity type:Organization
Organization Name:TRI-COUNTY COMMUNITY ACTION AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-497-6650
Mailing Address - Street 1:110 COHANSEY ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1922
Mailing Address - Country:US
Mailing Address - Phone:856-497-6650
Mailing Address - Fax:
Practice Address - Street 1:110 COHANSEY ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1922
Practice Address - Country:US
Practice Address - Phone:856-497-6650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)