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General NPI Number Information
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NPI Number | 1528658739
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Entity Type | Organization
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Legal Business Name | WAYFARE COUNSELING, LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 328 CHANGEBRIDGE RD STE 200
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City | PINE BROOK
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State | NJ
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Zip | 07058-9805
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Country | US
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Telephone | 973-617-0042
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Fax | 973-850-0711
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Provider Business Mailing Address
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Address Line | 328 CHANGEBRIDGE RD STE 200
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City | PINE BROOK
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State | NJ
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Zip | 07058-9805
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Country | US
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Telephone | 973-617-0042
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Fax | 973-850-0711
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MICHAEL T. COCUZZA
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Credential | MS, LPC, LCADC
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Telephone | 973-617-0042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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