Provider Demographics
NPI:1861544629
Name:COUNSELING AND PSYCHOTHERAPY SERVICES INC
Entity type:Organization
Organization Name:COUNSELING AND PSYCHOTHERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PINE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, BCETS
Authorized Official - Phone:609-801-9008
Mailing Address - Street 1:3 SAINT MICHAELS CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-3525
Mailing Address - Country:US
Mailing Address - Phone:609-801-9008
Mailing Address - Fax:
Practice Address - Street 1:127 RED LION RD
Practice Address - Street 2:SUITE D
Practice Address - City:SOUTHAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08088-8830
Practice Address - Country:US
Practice Address - Phone:609-801-9555
Practice Address - Fax:609-801-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty