Healthcare Provider Details

I. General information

NPI: 1841580883
Provider Name (Legal Business Name): WELLNESS FROM WITHIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 E MAIN ST
FREEHOLD NJ
07728-2282
US

IV. Provider business mailing address

34 E MAIN ST
FREEHOLD NJ
07728-2282
US

V. Phone/Fax

Practice location:
  • Phone: 609-755-5060
  • Fax:
Mailing address:
  • Phone: 609-755-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. GAGANDEEP SINGH
Title or Position: FOUNDER/OWNER
Credential: M.D.
Phone: 908-675-6010