NPIMap

Organization Active NPI

The Wounded Healer, Inc. D/B/a My Friends House Family Counseling Serv

  • Community/Behavioral Health Agency
  • Woodbury Heights, NJ
National Provider Identifier
1093932550
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2000403 Issued in NJ
Legal business name
THE WOUNDED HEALER, INC. D/B/A MY FRIENDS HOUSE FAMILY COUNSELING SERV
Practice address
371 Glassboro Road
Woodbury Heights, NJ 08097-1026
Phone
(856) 669-6900
Fax
(856) 384-0366
NPI assigned
Apr 19, 2007
Last updated
May 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Authorized official

Name
Mr. Michael Dulude
Title
Cfo
Phone
(856) 669-6900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 23143 NJ
Community/Behavioral Health Agency 251S00000X 2000403 NJ Primary

Addresses

Primary practice location

371 Glassboro Road
Woodbury Heights, NJ 08097-1026

Mailing address

371 Glassboro Road
Woodbury Heights, NJ 08097-1026
Phone (856) 669-6900

Other identifiers 1

IdentifierTypeStateIssuer
8936404MedicaidNJ

Other names 1

  • The Wounded Healer, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
The Wounded Healer Inc Dba My Friends House Family Counseling Serv5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1093932550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 GLASSBORO ROAD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971026",
            "telephone_number": "856-669-6900",
            "fax_number": "856-384-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 GLASSBORO ROAD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971026",
            "telephone_number": "856-669-6900",
            "fax_number": "856-384-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WOUNDED HEALER, INC. D/B/A MY FRIENDS HOUSE FAMILY COUNSELING SERV",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "DULUDE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-669-6900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "23143",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "2000403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wounded Healer, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Woodbury Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.