Provider Demographics
NPI:1063123180
Name:HOPE-FULLNESS COUNSELING, PREVENTION, AND EDUCATION
Entity type:Organization
Organization Name:HOPE-FULLNESS COUNSELING, PREVENTION, AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-687-9796
Mailing Address - Street 1:25 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BELFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07718-1046
Mailing Address - Country:US
Mailing Address - Phone:732-687-9796
Mailing Address - Fax:732-769-2397
Practice Address - Street 1:25 W PARK AVE
Practice Address - Street 2:
Practice Address - City:BELFORD
Practice Address - State:NJ
Practice Address - Zip Code:07718-1046
Practice Address - Country:US
Practice Address - Phone:732-687-9796
Practice Address - Fax:732-769-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health