Healthcare Provider Details

I. General information

NPI: 1750598496
Provider Name (Legal Business Name): WESTFIELD MARRIAGE AND FAMILY THERAPY GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MORRIS AVE SUITE 302
SPRINGFIELD NJ
07081-1027
US

IV. Provider business mailing address

500 MORRIS AVE SUITE 302
SPRINGFIELD NJ
07081-1027
US

V. Phone/Fax

Practice location:
  • Phone: 973-376-6336
  • Fax: 973-376-7304
Mailing address:
  • Phone: 973-376-6336
  • Fax: 973-376-7304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FI00038300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number392
License Number State

VIII. Authorized Official

Name: DR. ROGER WALLACE PLANTIKOW
Title or Position: PRESIDENT
Credential: D.MIN.
Phone: 973-376-6336