Active NPI
Marianne Wishbow
- Professional Counselor
- Stirling, NJ
National Provider Identifier
1417579145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00717900
- Practice address
- 1390 Valley Rd
Stirling, NJ 07980-1346 - Phone
- (908) 809-9463
- NPI assigned
- May 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00240000 | NJ | |
| Professional Counselor | 101YP2500X | 37PC00717900 | NJ | Primary |
Addresses
Primary practice location
1390 Valley Rd
Stirling, NJ 07980-1346
Mailing address
528 Giles Ave
Middlesex, NJ 08846-2407
Phone (732) 857-7645
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00240000 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 37PC00717900 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589500800000",
"number": "1417579145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 GILES AVE",
"city": "MIDDLESEX",
"state": "NJ",
"postal_code": "088462407",
"telephone_number": "732-857-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 VALLEY RD",
"city": "STIRLING",
"state": "NJ",
"postal_code": "079801346",
"telephone_number": "908-809-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISHBOW",
"first_name": "MARIANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-15",
"last_updated": "2020-05-15",
"certification_date": "2020-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37LC00240000",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00717900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stirling, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.