Eagles Wings Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

374PC00371200 Issued in NJ

Legal business name

EAGLES WINGS COUNSELING SERVICES

Practice address

505 Balsam Rd
Cherry Hill, NJ 08003-3201

Phone

(609) 353-4075

NPI assigned

Feb 26, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Keisha Sparrow, MA, LPC

Title

Owner

Phone

(856) 298-1367

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1275958340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 KINGS HWY N",
            "address_2": "SUITE 207",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342304",
            "telephone_number": "856-298-1367",
            "fax_number": "856-295-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BALSAM RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033201",
            "telephone_number": "609-353-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES WINGS COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-26",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "SPARROW",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-298-1367",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "374PC00371200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.