MEDICARE: WELLNESS COUNSELING OF BERGEN COUNTY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275020141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS COUNSELING OF BERGEN COUNTY

Provider Business Mailing Address
First Line	:	70 W ALLENDALE AVE STE D
Second Line	:
City	:	ALLENDALE
State	:	NJ
Zip	:	07401-1798
Country	:	US
Telephone Number	:	12-661-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 W ALLENDALE AVE STE D
Second Line	:
City	:	ALLENDALE
State	:	NJ
Zip	:	07401-1798
Country	:	US
Telephone Number	:	12-661-8070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JENNIFER POLITIS
Credential	:	PHD, LPC
Telephone Number	:	201-661-8070

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	11/19/2019

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Directions to “WELLNESS COUNSELING OF BERGEN COUNTY ” Practice Location

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