Healthcare Provider Details

I. General information

NPI: 1528658739
Provider Name (Legal Business Name): WAYFARE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 CHANGEBRIDGE RD STE 200
PINE BROOK NJ
07058-9805
US

IV. Provider business mailing address

328 CHANGEBRIDGE RD STE 200
PINE BROOK NJ
07058-9805
US

V. Phone/Fax

Practice location:
  • Phone: 973-617-0042
  • Fax: 973-850-0711
Mailing address:
  • Phone: 973-617-0042
  • Fax: 973-850-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL T. COCUZZA
Title or Position: CLINICAL DIRECTOR
Credential: MS, LPC, LCADC
Phone: 973-617-0042