Integrative Journey Modern Psychotherapy Co

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTEGRATIVE JOURNEY MODERN PSYCHOTHERAPY CO

Practice address

171 Main St Ste 102
Matawan, NJ 07747-3177

Phone

(609) 759-0018

NPI assigned

Oct 4, 2023

Organization subpart

No

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

Authorized official

Name

Meredith Futernick-Gerak, LPC, LMHC, ACSNPI 1255865804

Title

Owner

Phone

(718) 431-5641

Specialties & licenses 1

Addresses

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.

• Meredith Futernick-Gerak, LPC, LMHC

  • Mental Health Counselor
  • Matawan, NJ
  • NPI 1255865804
  NPD Authorized official

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1376323535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MORNING DEW CT",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 102",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473177",
            "telephone_number": "609-759-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE JOURNEY MODERN PSYCHOTHERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "FUTERNICK-GERAK",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-431-5641",
        "authorized_official_credential": "LPC, LMHC, ACS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.