Organization
INTEGRATED CARE CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA HAMMER (BILLING MANAGER)
(732) 389-0697
Entity
Organization
Contact information
Practice address
615 HOPE ROAD, BLDG 5B, 2ND FLOOR, EATONTOWN, NJ 07724-1277
(732) 389-0697
(732) 389-0611
Mailing address
134 LIGHTHOUSE DR, WARETOWN, NJ 08758-2015
(732) 389-0697
(732) 389-0611
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538285911
OWNER'S INDIVIDUAL NPI
NJ
01
—
1760812051
PARTNER'S INDIVIDUAL NPI
NJ
Enumeration date
09/19/2017
Last updated
03/15/2023
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