Counseling and Psychotherapy for Life LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

NJ37FI00166800 Issued in NJ

Legal business name

COUNSELING AND PSYCHOTHERAPY FOR LIFE LLC

Practice address

7 Nicole CT
Jackson, NJ 08527-2400

Phone

(732) 664-0772

Fax

(732) 928-6290

NPI assigned

Jul 23, 2012

Last updated

Aug 22, 2012By 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. William F Boan, ED.S. LMFTNPI 1881835395

Title

Owner/ Operator

Phone

(732) 664-0772

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William F. Boan, LMFT

  • Marriage & Family Therapist
  • Jackson, NJ
  • NPI 1881835395

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345593600000",
    "number": "1174878599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N COUNTY LINE RD",
            "address_2": "BLDG 3 SUITE 6",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271255",
            "telephone_number": "732-664-0772",
            "fax_number": "732-928-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 NICOLE CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272400",
            "telephone_number": "732-664-0772",
            "fax_number": "732-928-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND PSYCHOTHERAPY FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-08-22",
        "status": "A",
        "authorized_official_last_name": "BOAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "732-664-0772",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.S. LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "NJ37FI00166800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; 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.