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NPI Code Detail

MEDICARE: WAYNE COUNSELING AND FAMILY SERVICES

MEDICARE: WAYNE COUNSELING AND FAMILY SERVICES
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
1251S00000XCommunity/Behavioral Health Agency44SC05301500NJ

General Provider Information

NPI Number : 1558411868
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE COUNSELING AND FAMILY SERVICES
Provider Business Mailing Address
First Line : 40 MANCHESTER CT
Second Line :
City : WAYNE
State : NJ
Zip : 07470-3386
Country : US
Telephone Number : 973-305-6901
Fax Number :
Provider Business Practice Location Address
First Line : 1022 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-3209
Country : US
Telephone Number : 973-694-1234
Fax Number : 973-633-0992
Authorized Official
Title or Position : THERAPIST
Name : MR. JOSEPH MICHAEL TIERNEY
Credential : LCSW
Telephone Number : 973-694-1234
Provider Enumeration Date : 01/11/2007
Last Update Date : 08/22/2020

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Directions to “WAYNE COUNSELING AND FAMILY SERVICES ” Practice Location

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