Organization Name: | COOPERATIVE COUNSELING SERVICES, LLC |
NPI Number: | 1417080003 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LESLIE KIRSTEN MOORMAN (CEO) |
Mailing Address: | 1166 Puddingstone Rd Mountainside |
State: | NJ US |
Postal Code: | 070922010 |
Phone Number: | 9085770818 |
Fax Number: | 9086549026 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |