Provider Demographics
NPI:1457074262
Name:EQUANIMITY COUNSELING LLC
Entity type:Organization
Organization Name:EQUANIMITY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OUTPATIENT THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NAHI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:856-739-0402
Mailing Address - Street 1:455 PENN BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2821
Mailing Address - Country:US
Mailing Address - Phone:856-739-0402
Mailing Address - Fax:
Practice Address - Street 1:900 ROUTE 168 # E1-E2
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-3233
Practice Address - Country:US
Practice Address - Phone:856-271-4490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty