Healthcare Provider Details

I. General information

NPI: 1811832710
Provider Name (Legal Business Name): A THERAPIST IN TOMS RIVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 LACEY RD
FORKED RIVER NJ
08731-1533
US

IV. Provider business mailing address

267 TILLER AVE
BEACHWOOD NJ
08722-2714
US

V. Phone/Fax

Practice location:
  • Phone: 732-228-1746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WUNDERLICH
Title or Position: OWNER
Credential: MA LPC ACS
Phone: 732-228-1746