Organization Active NPI

North Jersey Wellness Center

  • Mental Health Counselor
  • North Bergen, NJ
National Provider Identifier
1629552963
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NORTH JERSEY WELLNESS CENTER
Practice address
8901 Kennedy Blvd Ste 4W
North Bergen, NJ 07047-5345
Phone
(201) 757-3800
NPI assigned
Sep 22, 2018
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Mr. Salvador Emerson Reyes, LPC, LCADCNPI 1346724978
Title
Director
Phone
(201) 757-3800

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

8901 Kennedy Blvd Ste 4W
North Bergen, NJ 07047-5345

Mailing address

556 Abbott Ave
Ridgefield, NJ 07657-2443
Phone (201) 724-2261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250918002153 NJ Part B Supplier - Clinic/Group Practice 5597269969 Receives reassigned benefits from 1 practitioner
Practice locations: North Bergen, NJ

National Provider Directory

National Provider Directory

Locations

8901 Kennedy Blvd
Ste 4W
North Bergen, NJ 07047
Phone (201) 757-3800

6515 Polk St
West New York, NJ 07093

Practitioners & affiliated clinicians

Practitioners 5

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": "1537574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1629552963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 ABBOTT AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076572443",
            "telephone_number": "201-724-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 KENNEDY BLVD STE 4W",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475345",
            "telephone_number": "201-757-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-22",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "SALVADOR",
        "authorized_official_middle_name": "EMERSON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-757-3800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.