Provider Demographics
NPI:1952169740
Name:WIND OF CHANGE MENTAL HEALTH COUNSELING LLC
Entity Type:Organization
Organization Name:WIND OF CHANGE MENTAL HEALTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:646-732-7097
Mailing Address - Street 1:13 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3460
Mailing Address - Country:US
Mailing Address - Phone:732-997-7008
Mailing Address - Fax:
Practice Address - Street 1:119 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1764
Practice Address - Country:US
Practice Address - Phone:732-997-7008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health