Provider Demographics
NPI:1528532793
Name:PROTEA COUNSELING
Entity type:Organization
Organization Name:PROTEA COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JACQUI
Authorized Official - Middle Name:
Authorized Official - Last Name:HURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-209-2008
Mailing Address - Street 1:80 KNIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:RUNNEMEDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08078-1744
Mailing Address - Country:US
Mailing Address - Phone:856-208-2009
Mailing Address - Fax:
Practice Address - Street 1:80 KNIGHT AVE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1744
Practice Address - Country:US
Practice Address - Phone:856-208-2009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty