Provider Demographics
NPI:1063775385
Name:NORTH BRUNSWICK COUNSELING & PSYCHOLOGICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:NORTH BRUNSWICK COUNSELING & PSYCHOLOGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/MSW
Authorized Official - Phone:910-371-0568
Mailing Address - Street 1:1107 NEW POINTE BLVD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4128
Mailing Address - Country:US
Mailing Address - Phone:910-371-0568
Mailing Address - Fax:910-383-2802
Practice Address - Street 1:1107 NEW POINTE BLVD
Practice Address - Street 2:SUITE 16
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4128
Practice Address - Country:US
Practice Address - Phone:910-371-0568
Practice Address - Fax:910-383-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0021261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty