Provider Demographics
NPI:1568348829
Name:GARDEN STATE COUNSELING CENTER LLC
Entity type:Organization
Organization Name:GARDEN STATE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNIPES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-231-2523
Mailing Address - Street 1:11-13 SUNFLOWER AVE # 1000
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3700
Mailing Address - Country:US
Mailing Address - Phone:413-231-2523
Mailing Address - Fax:
Practice Address - Street 1:11-13 SUNFLOWER AVE # 1000
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3700
Practice Address - Country:US
Practice Address - Phone:413-231-2523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)