Provider Demographics
NPI:1922162296
Name:REGIONAL COUNSELING SERVICES OF SOUTHERN NEW JERSEY
Entity type:Organization
Organization Name:REGIONAL COUNSELING SERVICES OF SOUTHERN NEW JERSEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:856-784-1001
Mailing Address - Street 1:LAUREL OAK CORPORATE CENTER
Mailing Address - Street 2:1000 HADDONFIELD-BERLIN ROAD, SUITE 207
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043
Mailing Address - Country:US
Mailing Address - Phone:856-784-1001
Mailing Address - Fax:856-784-5115
Practice Address - Street 1:LAUREL OAK CORPORATE CENTER
Practice Address - Street 2:1000 HADDONFIELD-BERLIN ROAD, SUITE 207
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-784-1001
Practice Address - Fax:856-784-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty