Provider Demographics
NPI:1699122853
Name:COUPLES THERAPY CENTER OF NEW JERSEY
Entity type:Organization
Organization Name:COUPLES THERAPY CENTER OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-246-3074
Mailing Address - Street 1:719 US HIGHWAY 206
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1536
Mailing Address - Country:US
Mailing Address - Phone:908-246-3074
Mailing Address - Fax:
Practice Address - Street 1:719 US HIGHWAY 206
Practice Address - Street 2:SUITE 204
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1536
Practice Address - Country:US
Practice Address - Phone:908-246-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00325600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty