Healthcare Provider Details

I. General information

NPI: 1649920422
Provider Name (Legal Business Name): MARCY WECKER-HERBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MAIN ST STE 101-A
WHITEHOUSE STATION NJ
08889-3737
US

IV. Provider business mailing address

470 RIDGEDALE AVE
EAST HANOVER NJ
07936-3074
US

V. Phone/Fax

Practice location:
  • Phone: 908-533-1777
  • Fax: 908-533-1777
Mailing address:
  • Phone: 973-515-1216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01166300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: