Organization Name: | INTENTIONAL HEARTS COUNSELING SERVICES |
NPI Number: | 1013386150 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORI MICHELLE NIXON (OWNER) |
Mailing Address: | 1806 Highway 35 Suite 203b Oakhurst |
State: | NJ US |
Postal Code: | 077552700 |
Phone Number: | 7328533050 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2015 |
NPI Last Update Date: | 09/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 37PC00432100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |