Organization Active NPI

Wisdom Spring Wellness Services

  • Psychologist
  • Union, NJ
National Provider Identifier
1104377803
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WISDOM SPRING WELLNESS SERVICES
Practice address
2191 Morris Ave
Union, NJ 07083-5927
Phone
(732) 595-7478
Fax
(732) 453-6200
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Dr. Ruben Lambert, PSYDNPI 1538618822
Title
Psychologist / Owner
Phone
(908) 377-9942

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

2191 Morris Ave
Union, NJ 07083-5927

Mailing address

2191 Morris Ave
Union, NJ 07083-5927
Phone (732) 595-7478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161212000681 NJ Part B Supplier - Clinic/Group Practice 6305126285 Receives reassigned benefits from 1 practitioner
Practice locations: Union, NJ

National Provider Directory

National Provider Directory

Locations

1115 E Jersey St
Elizabeth, NJ 07201
Phone (732) 595-7478

2191 Morris Ave
Ste 3
Union, NJ 07083
Phone (732) 595-7478

Practitioners & affiliated clinicians

Practitioners 3

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": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1104377803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835927",
            "telephone_number": "732-595-7478",
            "fax_number": "732-453-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835927",
            "telephone_number": "732-595-7478",
            "fax_number": "732-453-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM SPRING WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PSYCHOLOGIST / OWNER",
        "authorized_official_telephone_number": "908-377-9942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.