Provider Demographics
NPI:1952722001
Name:JOHN R SOPER, JR, MA, NCC, LPC & CLINICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JOHN R SOPER, JR, MA, NCC, LPC & CLINICAL ASSOCIATES, LLC
Other - Org Name:SOPER COUNSELING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SOPER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, NCC, LPC, ACS
Authorized Official - Phone:732-889-3089
Mailing Address - Street 1:500 RTE 33
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08535-8538
Mailing Address - Country:US
Mailing Address - Phone:732-889-3089
Mailing Address - Fax:732-671-4350
Practice Address - Street 1:500 RTE 33
Practice Address - Street 2:SUITE 2G
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08535-8538
Practice Address - Country:US
Practice Address - Phone:732-889-3089
Practice Address - Fax:732-671-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00041600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty