Provider Demographics
NPI:1871813469
Name:COUNSELING CENTER AT HAMILTON, LLC
Entity type:Organization
Organization Name:COUNSELING CENTER AT HAMILTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC NCC
Authorized Official - Phone:609-890-9998
Mailing Address - Street 1:2667 NOTTINGHAM WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-4116
Mailing Address - Country:US
Mailing Address - Phone:609-890-9998
Mailing Address - Fax:609-890-9998
Practice Address - Street 1:2667 NOTTINGHAM WAY STE 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-4116
Practice Address - Country:US
Practice Address - Phone:609-890-9998
Practice Address - Fax:609-890-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00017900101YM0800X
NJ44SC002899001041C0700X
PASW-011397-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty