Way of the Spirit Counseling Services Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

WAY OF THE SPIRIT COUNSELING SERVICES INC

Practice address

2600 Mount Ephraim Ave
Suite 405
Camden, NJ 08104-3236

Phone

(856) 963-7323

Fax

(856) 963-7324

NPI assigned

Sep 11, 2015

Organization subpart

No

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

Authorized official

Name

Jacqueline P Cooke, M.D.

Title

Medical Director

Phone

(856) 963-0500

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leroy Stanford Jr.

  • Addiction (Substance Use Disorder) Counselor
  • Camden, NJ
  • NPI 1013395052
  NPD (past)

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1518335249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 N 19TH STREET",
            "address_2": "SUITE B",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08105",
            "telephone_number": "856-963-7323",
            "fax_number": "856-963-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MOUNT EPHRAIM AVE",
            "address_2": "SUITE 405",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081043236",
            "telephone_number": "856-963-7323",
            "fax_number": "856-963-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAY OF THE SPIRIT COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "856-963-0500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492043LR",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael John Waverka
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• Colby Weaver, CRNP
• Jan Richard Weber, MD
• Kevin Wegner, OTR
• Margaret Weidenmiller, CRNA

• Substance Use Disorder Rehabilitation Clinic/Center in Camden, NJ
• Providers in Camden, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.