Provider Demographics
NPI:1184781320
Name:TRANQUILITY COUNSELING & WELLNESS CENTER
Entity type:Organization
Organization Name:TRANQUILITY COUNSELING & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-580-4964
Mailing Address - Street 1:30 MAIN ST
Mailing Address - Street 2:SUITE 30-2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7436
Mailing Address - Country:US
Mailing Address - Phone:732-580-4964
Mailing Address - Fax:732-901-9124
Practice Address - Street 1:30 MAIN ST
Practice Address - Street 2:SUITE 30-2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7436
Practice Address - Country:US
Practice Address - Phone:732-580-4964
Practice Address - Fax:732-901-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC003096000101YP2500X
NJ44SC052989001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2201451OtherCIGNA PROVIDER ID
NJ0007615619Medicare UPIN