Provider Demographics
NPI:1255699013
Name:POWER COUNSELING AND TREATMENT SERVICES, LLC
Entity type:Organization
Organization Name:POWER COUNSELING AND TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AZUBIKE
Authorized Official - Middle Name:INNOCENT
Authorized Official - Last Name:ALICHE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:202-813-0454
Mailing Address - Street 1:6828 WALKWAY CT STE B
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-6106
Mailing Address - Country:US
Mailing Address - Phone:202-813-0454
Mailing Address - Fax:202-813-0454
Practice Address - Street 1:1071 E LANDIS AVE STE 3
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4060
Practice Address - Country:US
Practice Address - Phone:202-813-0454
Practice Address - Fax:202-813-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ243369YHYJMedicare PIN