490 Counseling
Organization Active NPI Clinical Social Worker · Eatontown, NJ
NPI 1962008250 · NPPES record last updated Dec 10, 2020
Key facts
- NPI
- 1962008250
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- 490 COUNSELING
- Practice address
- 48B Southbrook Dr
Eatontown, NJ 07724-1829 - Phone
- (973) 862-3111
- NPI assigned
- Dec 10, 2020
- Organization subpart
- No
Authorized official
- Name
- Julianna Calleo
- Title
- Ceo
- Phone
- (973) 862-3111
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Clinical Social Worker |
1041C0700X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
48B Southbrook Dr
Eatontown, NJ 07724-1829
Mailing address
48B Southbrook Dr
Eatontown, NJ 07724-1829
Phone (973) 862-3111
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All providers in Eatontown, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.