MEDICARE: MARC WAX LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37AC00486900	NJ
2	101YP2500X	Professional Counselor	37PC01090900	NJ

General Provider Information

NPI Number	:	1376185728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC WAX LPC

Provider Business Mailing Address
First Line	:	81 CROOKED STICK RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-4032
Country	:	US
Telephone Number	:	609-916-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 CROOKED STICK RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-4032
Country	:	US
Telephone Number	:	609-916-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2019
Last Update Date	:	07/02/2025

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Directions to “ MARC WAX LPC” Practice Location

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