Provider Demographics
NPI:1366766438
Name:HEALTHMARK COUNSELING, LLC
Entity type:Organization
Organization Name:HEALTHMARK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:856-829-3385
Mailing Address - Street 1:101 ROUTE 130 S
Mailing Address - Street 2:MADISON BUILDING, SUITE 321
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2845
Mailing Address - Country:US
Mailing Address - Phone:856-829-3385
Mailing Address - Fax:
Practice Address - Street 1:101 ROUTE 130 S
Practice Address - Street 2:MADISON BUILDING, SUITE 321
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2845
Practice Address - Country:US
Practice Address - Phone:856-829-3385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00305000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty