NPIMap

Organization Active NPI

Mindful Therapy of Monmouth County LLC

  • Clinical Social Worker
  • Matawan, NJ
National Provider Identifier
1881276442
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL THERAPY OF MONMOUTH COUNTY LLC
Practice address
30 Freneau Ave BLDG a
Matawan, NJ 07747-3390
Phone
(732) 705-1561
Fax
(732) 791-9057
NPI assigned
Apr 23, 2021
Last updated
Apr 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Mrs. Nicole Rachel Wegweiser, LCSWNPI 1215185004
Title
Owner
Phone
(732) 705-1561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

30 Freneau Ave BLDG a
Matawan, NJ 07747-3390

Mailing address

30 Freneau Ave BLDG a
Matawan, NJ 07747-3390
Phone (732) 705-1561

Other identifiers 1

IdentifierTypeStateIssuer
1215185004OtherNJNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address therapy@nicolewegweiser.com Direct

National Provider Directory

National Provider Directory

Locations

30 Freneau Ave
Ste 2B
Matawan, NJ 07747
Phone (732) 705-1561

Practitioners & affiliated clinicians

Practitioners 1

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": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1881276442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FRENEAU AVE BLDG A",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473390",
            "telephone_number": "732-705-1561",
            "fax_number": "732-791-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FRENEAU AVE BLDG A",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473390",
            "telephone_number": "732-705-1561",
            "fax_number": "732-791-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL THERAPY OF MONMOUTH COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "WEGWEISER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-705-1561",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215185004",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therapy@nicolewegweiser.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 Freneau Ave Bldg A",
            "city": "Matawan",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077473390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.