| Organization Name: | SOUTH JERSEY PSYCHOLOGICAL AND COUNSELING SERVICES, LLC |
| NPI Number: | 1558765594 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN KRAVCHUCK (PSYCHOLOGIST) |
| Mailing Address: | 140 S Broadway Ste 7 Pitman |
| State: | NJ US |
| Postal Code: | 080712235 |
| Phone Number: | 8443657676 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2014 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 35S100500400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |