NPIMap

Organization Active NPI

Center for Cognitive Behavioral Therapy and Mindfulness

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1013627827
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CENTER FOR COGNITIVE BEHAVIORAL THERAPY AND MINDFULNESS
Practice address
3720 Spruce St Ste 409
Philadelphia, PA 19104-4115
Phone
(844) 287-4228
NPI assigned
Dec 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Suraji Wagage, PHDNPI 1154911956
Title
Director, Clinical Psychologist
Phone
(973) 600-7423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

3720 Spruce St Ste 409
Philadelphia, PA 19104-4115

Mailing address

3720 Spruce St Ste 409
Philadelphia, PA 19104-4115

National Provider Directory

National Provider Directory

Locations

3720 Spruce St
Ste 409
Philadelphia, PA 19104
Phone (844) 287-4228

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1013627827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 SPRUCE ST STE 409",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 SPRUCE ST STE 409",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044115",
            "telephone_number": "844-287-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COGNITIVE BEHAVIORAL THERAPY AND MINDFULNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "WAGAGE",
        "authorized_official_first_name": "SURAJI",
        "authorized_official_title_or_position": "DIRECTOR, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "973-600-7423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.