NPIMap

Organization Active NPI

Anxiety Treatment Center, LLC.

  • Clinical Social Worker
  • South Bound Brook, NJ
National Provider Identifier
1356760813
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05343200 Issued in NJ
Legal business name
ANXIETY TREATMENT CENTER, LLC.
Practice address
15 Patriots Path
South Bound Brook, NJ 08880-1495
Phone
(215) 962-0701
Fax
(732) 356-1883
NPI assigned
Apr 14, 2014
Last updated
Apr 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Mr. Richard G. Wagner, LCSWNPI 1568666220
Title
Owner
Phone
(215) 962-0701

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
Clinical Social Worker 1041C0700X 44SC05343200 NJ Primary

Addresses

Primary practice location

15 Patriots Path
South Bound Brook, NJ 08880-1495

Mailing address

15 Patriots Path
South Bound Brook, NJ 08880-1495
Phone (215) 962-0701

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1356760813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PATRIOTS PATH",
            "city": "SOUTH BOUND BROOK",
            "state": "NJ",
            "postal_code": "088801495",
            "telephone_number": "215-962-0701",
            "fax_number": "732-356-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PATRIOTS PATH",
            "city": "SOUTH BOUND BROOK",
            "state": "NJ",
            "postal_code": "088801495",
            "telephone_number": "215-962-0701",
            "fax_number": "732-356-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY TREATMENT CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-962-0701",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05343200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bound Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.