Provider Demographics
NPI:1427492263
Name:AGAPE COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:AGAPE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEMING HOULE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:609-242-0086
Mailing Address - Street 1:815 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-1706
Mailing Address - Country:US
Mailing Address - Phone:609-242-0086
Mailing Address - Fax:609-242-0087
Practice Address - Street 1:815 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-1706
Practice Address - Country:US
Practice Address - Phone:609-242-0086
Practice Address - Fax:609-242-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000190261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0031585Medicaid