Organization
COUNSELING SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAHARKA ABU SANKARA (MANAGING MEMBER)
(732) 337-8323
Entity
Organization
Contact information
Practice address
97 APPLE ST STE 3, TINTON FALLS, NJ 07724-2637
(732) 337-8323
Mailing address
36 SHREWSBURY DR, LONG BRANCH, NJ 07740-7619
(732) 272-1340
(732) 272-1390
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05644200
NJ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
44SC05644200
NJ
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
37LC00174900
NJ
Other
Enumeration date
04/09/2013
Last updated
10/04/2024
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