Provider Demographics
NPI:1902315484
Name:CAPE COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:CAPE COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-778-6101
Mailing Address - Street 1:1129 S ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2752
Mailing Address - Country:US
Mailing Address - Phone:609-778-6103
Mailing Address - Fax:609-778-6173
Practice Address - Street 1:1046 ROUTE 47 S BLDG B
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1506
Practice Address - Country:US
Practice Address - Phone:609-778-6211
Practice Address - Fax:609-778-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0019909Medicaid