Provider Demographics
NPI:1932791860
Name:MIND & BODY COUNSELING & COACHING SERVICES, LLP
Entity Type:Organization
Organization Name:MIND & BODY COUNSELING & COACHING SERVICES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-702-2905
Mailing Address - Street 1:865 STATE ROUTE 33 STE 3-1117
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8475
Mailing Address - Country:US
Mailing Address - Phone:732-702-2905
Mailing Address - Fax:
Practice Address - Street 1:865 STATE ROUTE 33 STE 3-1117
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8475
Practice Address - Country:US
Practice Address - Phone:732-702-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty