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NPI Code Detail

MEDICARE: WAYNE COUNSELING CENTER, INC.

MEDICARE: WAYNE COUNSELING CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
31041C0700XClinical Social Worker41642NJ
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
5251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063491967
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE COUNSELING CENTER, INC.
Provider Business Mailing Address
First Line : 1022 HAMBURG TURNPIKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-3209
Country : US
Telephone Number : 973-694-1234
Fax Number : 973-633-0992
Provider Business Practice Location Address
First Line : 1022 HAMBURG TURNPIKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-3209
Country : US
Telephone Number : 973-694-1234
Fax Number : 973-633-0992
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JANE WILLENBORG
Credential : LPC, LCADC
Telephone Number : 973-694-1234
Provider Enumeration Date : 01/10/2006
Last Update Date : 04/10/2025

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