| Breaking The Chain Counseling, Llc | |
|
295 Main St 2 Fl Chatham NJ 07928-2424 | |
| (732) 298-0301 | |
| Not Available |
| Full Name | Breaking The Chain Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 295 Main St, Chatham, New Jersey |
| Authorized Official Name and Position | Daniel P Pitzer (PRESIDENT) |
| Authorized Official Contact | 7322980301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breaking The Chain Counseling, Llc 651 Monmouth Ave Port Monmouth NJ 07758-1517 Ph: (732) 298-0301 | Breaking The Chain Counseling, Llc 295 Main St 2 Fl Chatham NJ 07928-2424 Ph: (732) 298-0301 |
| NPI Number | 1447315395 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 07/16/2014 |
| Medicare PECOS PAC ID | 8820127988 |
|---|---|
| Medicare Enrollment ID | O20100527000521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447315395 | NPI | - | NPPES |
| 179291 | Other | NJ | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05185600 (New Jersey) | Secondary |
| 1041C0700X | Social Worker - Clinical | 44SC05185500 (New Jersey) | Primary |
| Provider Name | Daniel P Pitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043543663 PECOS PAC ID: 9537159819 Enrollment ID: I20040518000109 |
| Provider Name | Michele H Pitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346571668 PECOS PAC ID: 1951376821 Enrollment ID: I20040902000068 |
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