Organization
CCC COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEDIEDJAH MOSHE RODRIGUES PEREIRA MSW, LCSW, LCADC (OWNER)
(732) 814-4648
Entity
Organization
Contact information
Practice address
1212 TODD CT, LAKEWOOD, NJ 08701-2256
(609) 225-9355
Mailing address
1212 TODD CT, LAKEWOOD, NJ 08701-2256
(732) 814-4648
(609) 228-8896
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
11/16/2014
Last updated
02/26/2023
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