| The Pastors Lounge Llc | |
|
11 Tamarack Rd Edison NJ 08820-3630 | |
| (908) 844-1080 | |
| Not Available |
| Full Name | The Pastors Lounge Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11 Tamarack Rd, Edison, New Jersey |
| Authorized Official Name and Position | Sheridan Jenice Tennant-straube (CO OWNER AND CLINICIAN) |
| Authorized Official Contact | 9088441080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Pastors Lounge Llc 192 Bennetts Ln Somerset NJ 08873-5051 Ph: (908) 844-1080 | The Pastors Lounge Llc 11 Tamarack Rd Edison NJ 08820-3630 Ph: (908) 844-1080 |
| NPI Number | 1093535395 |
|---|---|
| Provider Enumeration Date | 10/12/2024 |
| Last Update Date | 10/12/2024 |
| Certification Date | 10/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093535395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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