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General NPI Number Information
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NPI Number | 1750598496
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Entity Type | Organization
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Legal Business Name | WESTFIELD MARRIAGE AND FAMILY THERAPY GROUP, PA
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 500 MORRIS AVE SUITE 302
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1027
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Country | US
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Telephone | 973-376-6336
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Fax | 973-376-7304
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Provider Business Mailing Address
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Address Line | 500 MORRIS AVE SUITE 302
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1027
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Country | US
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Telephone | 973-376-6336
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Fax | 973-376-7304
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER WALLACE PLANTIKOW
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Credential | D.MIN.
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Telephone | 973-376-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FI00038300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 392
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License Number State |
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