Epiphany Wellness

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

EPIPHANY WELLNESS

Practice address

461 Route 168
Blackwood, NJ 08012-1457

Phone

(215) 526-8093

NPI assigned

Aug 25, 2021

Last updated

Aug 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Shawn McBrien

Title

Co Founder/Coo

Phone

(215) 526-8093

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1053088336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BEECHNUT LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463806",
            "telephone_number": "215-526-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 ROUTE 168",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080121457",
            "telephone_number": "215-526-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "MCBRIEN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "CO FOUNDER/COO",
        "authorized_official_telephone_number": "215-526-8093",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.