Provider Demographics
NPI:1861233264
Name:EAST COAST COUNSELING SERVICES
Entity type:Organization
Organization Name:EAST COAST COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-651-1905
Mailing Address - Street 1:91 POMPTON AVE # 93
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-2013
Mailing Address - Country:US
Mailing Address - Phone:973-651-1905
Mailing Address - Fax:
Practice Address - Street 1:91 POMPTON AVE # 93
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2013
Practice Address - Country:US
Practice Address - Phone:973-651-1905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty