NPIMap

Organization Active NPI

Bethel Family & Youth Resource Center

  • Preferred Provider Organization
  • Newark, NJ
National Provider Identifier
1629216643
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
2000126-08 Issued in NJ
Legal business name
BETHEL FAMILY & YOUTH RESOURCE CENTER
Doing business as
Bethel Counseling Services
Practice address
65 Pierce St
Newark, NJ 07103-1716
Phone
(973) 643-6565
Fax
(862) 763-5071
NPI assigned
Jan 29, 2009
Organization subpart
Yes
Parent organization
BETHEL COUNSELING SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Authorized official

Name
Dr. Marian Osborne, LCADC
Title
Clinical Director
Phone
(973) 643-6565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 2000126-08 NJ Primary

Addresses

Primary practice location

65 Pierce St
Newark, NJ 07103-1716

Mailing address

65 Pierce St
Newark, NJ 07103-1716
Phone (973) 643-6565

Other names 1

  • Bethel Counseling Services Doing business as

National Provider Directory

National Provider Directory
Part of
Bethel Family Youth Resource Center

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1629216643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PIERCE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071031716",
            "telephone_number": "973-643-6565",
            "fax_number": "862-763-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PIERCE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071031716",
            "telephone_number": "973-643-6565",
            "fax_number": "862-763-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL FAMILY & YOUTH RESOURCE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETHEL COUNSELING SERVICES",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-643-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "2000126-08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethel Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.