Provider Demographics
NPI:1528658739
Name:WAYFARE COUNSELING, LLC
Entity type:Organization
Organization Name:WAYFARE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:COCUZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LCADC
Authorized Official - Phone:973-617-0042
Mailing Address - Street 1:328 CHANGEBRIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9805
Mailing Address - Country:US
Mailing Address - Phone:973-617-0042
Mailing Address - Fax:973-850-0711
Practice Address - Street 1:328 CHANGEBRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9805
Practice Address - Country:US
Practice Address - Phone:973-617-0042
Practice Address - Fax:973-850-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty