Progressive Wellness & Therapy Group of New Jersey LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PROGRESSIVE WELLNESS & THERAPY GROUP OF NEW JERSEY LLC

Practice address

350 W Passaic St
Rochelle Park, NJ 07662-3073

Phone

(201) 822-1232

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Thabatha BorerNPI 1922760313

Title

Owner/President

Phone

(201) 822-1232

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Thabatha Borer, LPC

  • Professional Counselor
  • Rochelle Park, NJ
  • NPI 1922760313
  NPD Authorized official

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1811602014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MIDLAND AVE UNIT 131",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070326806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W PASSAIC ST",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623073",
            "telephone_number": "201-822-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE WELLNESS & THERAPY GROUP OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "BORER",
        "authorized_official_first_name": "THABATHA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "201-822-1232"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Rochelle Park, NJ
• Providers in Rochelle Park, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.