Gary Michael Furtak, PEER SPECIALIST

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

725 Airport Rd Ste 7G
Lakewood, NJ 08701-5968

Phone

(732) 276-1510

Fax

(732) 363-5537

NPI assigned

Sep 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Preferred Behavioral Health of New Jersey, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Barnegat, NJ
  • NPI 1720773526
  NPD (past)
• Preferred Behavioral Health of NJ

  • Adult Mental Health Clinic/Center
  • Lakewood, NJ
  • NPI 1598999666
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1710608351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087018036",
            "telephone_number": "732-276-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AIRPORT RD STE 7G",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015968",
            "telephone_number": "732-276-1510",
            "fax_number": "732-363-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURTAK",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PEER  SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Fuentes, BCBA, LBA
• Hilary Fuirita, PA
• Full Circle Therapy
• Hinda Fund
• Mindy Furst, MSED, BCBA
• G Ny Applied Behavior Analysis PLLC
• Suzanne Gabriele
• Richard L Gaines, DMD
• Katherine Gallagher, PA-C
• Maryanne Galloway, LCSW

• Mental Health Counselor in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.