NPIMap

Organization Active NPI

The Wounded Healer, Inc. D/B/a My Friends House Family Counseling Serv

Doing business as My Friends House Family Counseling Service

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbury Heights, NJ
National Provider Identifier
1912437914
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
THE WOUNDED HEALER, INC. D/B/A MY FRIENDS HOUSE FAMILY COUNSELING SERV
Doing business as
My Friends House Family Counseling Service
Practice address
371 Glassboro Rd
Woodbury Heights, NJ 08097-1026
Phone
(856) 669-6900
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Authorized official

Name
Mr. Robert Laguarina Jr.
Title
Ceo
Phone
(856) 669-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

371 Glassboro Rd
Woodbury Heights, NJ 08097-1026

Mailing address

371 Glassboro Rd
Woodbury Heights, NJ 08097-1026
Phone (856) 669-6900

Other identifiers 1

IdentifierTypeStateIssuer
0443867MedicaidNJ

Other names 1

  • My Friends House Family Counseling Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Wounded Healer Inc Dba My Friends House Family Counseling Serv5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1912437914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 GLASSBORO RD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971026",
            "telephone_number": "856-669-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 GLASSBORO RD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971026",
            "telephone_number": "856-669-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WOUNDED HEALER, INC. D/B/A MY FRIENDS HOUSE FAMILY COUNSELING SERV",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "LAGUARINA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-669-6900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443867",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Friends House Family Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "My Friends House Family Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.