Individual provider Active NPI

Robert W Wunderlich Jr., LPC

  • Professional Counselor
  • Bayville, NJ
National Provider Identifier
1639425705
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00514400 Issued in NJ
Practice address
160 Route 9
Bayville, NJ 08721-1229
Phone
(732) 349-5550
Fax
(732) 349-0841
NPI assigned
Jul 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00514400 NJ Primary

Addresses

Primary practice location

160 Route 9
Bayville, NJ 08721-1229

Mailing address

160 Route 9
Bayville, NJ 08721-1229
Phone (732) 349-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215002972 NJ Practitioner - Mental Health Counselor 1153578125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00514400NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Therapist in Toms River Current Accepting new patients
Ocean Mental Health Services Inc CurrentSince Jan 13, 2024 Accepting new patients

Locations

160 US Highway 9
Bayville, NJ 08721
Phone (732) 349-1977

687 Route 9
Bayville, NJ 08721
Phone (732) 269-4849

535 Lacey Rd
Ste 1
Forked River, NJ 08731
Phone (732) 688-2058

40 Bey Lea Rd
Bldg A
Toms River, NJ 08753
Phone (732) 240-3760

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1639425705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ROUTE 9",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550",
            "fax_number": "732-349-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ROUTE 9",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550",
            "fax_number": "732-349-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-26",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00514400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayville, NJ

Sources for this page

Verify at the official NPI Registry.