KWENYAN PROFESSIONAL HEALTH SERVICES, LLC (NPI# 1609335736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609335736 |
| Entity Type | Organization |
| Organization Name | KWENYAN PROFESSIONAL HEALTH SERVICES, LLC |
| Practice Address |
200 South St New Providence NJ 07974-2151 |
| Mailing Address |
19 Hutton Ave West Orange NJ 07052-4803 |
| Practice Telephone | 9085162338 |
| Practice Fax Number | 8663768262 |
| Mailing Telephone | 6092845822 |
| Mailing Fax Number | 8663768262 |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |
| Authorized Official Name | DR. DR. DANIEL ESTRADA CASSELL, PH.D., MPH (PRESIDENT/CEO: ADMINISTRATOR) |
| Authorized Official Telephone | 2154323702 |
| Authorized Official Credential | PH.D., MPH |
| Is Organization Subpart | Y |
| Parent Organization Name | KWENYAN PROFESSIONAL HEALTH SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | NJ OFFICE OF LICENSING: OUTPATIENT MENTAL HEALTH SERVICES | 101950404 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003392374 | Kwenyan Professional Health Services, LLC | Clinic/Center | 291 Pickford Ave, Phillipsburg, NJ 08865-1626 | 2018-07-19 |
| 1205312766 | Kwenyan Professional Health Services, LLC | Counselor | 291 Pickford Ave, Phillipsburg, NJ 08865-1626 | 2018-07-17 |
| 1285928457 | Kwenyan Professional Health Services, LLC | Clinic/Center | 60 Evergreen Pl, Suite 500, East Orange, NJ 07018-2106 | 2011-06-06 |
| 1326368267 | Kwenyan Professional Health Services, LLC | Clinic/Center | 60 Evergreen Pl, Suite 500, East Orange, NJ 07018-2106 | 2010-06-02 |
| 1457671372 | Kwenyan Professional Health Services, LLC | Clinic/Center | 60 Evergreen Pl, Suite 500, East Orange, NJ 07018-2106 | 2010-06-02 |
| 1629221239 | Kwenyan Professional Health Services, LLC | Psychologist | 60 Evergreen Pl, Suite 500, East Orange, NJ 07018-2106 | 2008-10-28 |
| Street Address |
200 SOUTH ST |
| City | NEW PROVIDENCE |
| State | NJ |
| Zip Code | 07974-2151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457919474 | Helena Rebecca Kremen | Clinic/Center | 200 South St, New Providence, NJ 07974-2151 | 2019-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841775996 | A & J Majestic Care, LLC | In Home Supportive Care | 36 High Street, New Providence, NJ 07974 | 2018-09-25 |
| 1790222131 | Lantern Hill, Inc. | Skilled Nursing Facility | 537 Mountain Avenue, Attn: Extended Care Adminstrator, New Providence, NJ 07974 | 2017-01-24 |
| 1770960585 | Brett Pearsall | Chiropractor | 571 Central Ave Ste 103, New Providence, NJ 07974 | 2015-04-30 |
| 1548591340 | Sushmita Srivastav | Internal Medicine | 535 Mountain Ave, New Providence, NJ 07974 | 2010-01-19 |
| 1548406465 | Benjamin Mark Schneider | Radiology | 1811 Springfield Avenue, Summit Radiological Associates, New Providence, NJ 07974 | 2008-12-23 |
| 1033314042 | Jeffrey T Leary | Orthopaedic Surgery | 550 Central Ave Ste 500, New Providence, NJ 07974 | 2007-06-19 |
| 1336369925 | James Michael Rubino | Dentist | 598 Central Avenue, New Providence, NJ 07974 | 2007-04-26 |
| 1194942839 | Patricia A Baroff | Social Worker | 114 Glenside Road, Murray Hill, NJ 07974 | 2007-04-20 |
| 1497873244 | Gastrocare, LLC | Internal Medicine | 571 Central Avenue, Suite 112, New Providence, NJ 07974 | 2007-03-27 |
| 1629196134 | Carlos Moglianesi, D.m.d. PC | Dentist | 1806 Springfield Ave., New Providence, NJ 07974 | 2007-03-26 |
| Find all providers in zip 07974 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104954395 | John Patrick Egan II | Counselor | 72 Floral Ave, New Providence, NJ 07974-1511 | 2007-03-01 |
| 1407272263 | Thomas Dwyer | Counselor | 72 Floral Ave, New Providence, NJ 07974-1565 | 2014-03-17 |
| 1962672923 | Horizon Hill Associates | Counselor | 72 Floral Ave, New Providence, NJ 07974-1565 | 2008-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366042525 | Haydee Pimentel | Counselor | 1306 Fox Run Dr, Plainsboro, NJ 08536-2665 | 2020-10-27 |
| 1750981197 | Timothy Lowe | Counselor | 240 E Westfield Ave Apt C18, Roselle Park, NJ 07204-2326 | 2020-10-26 |
| 1417556069 | Nancy W Bodnar | Counselor | 52 Long Hill Rd, Long Valley, NJ 07853-3074 | 2020-10-23 |
| 1497354260 | Michele Marie Bruce | Counselor | 5 Horizon Rd Apt 306, Fort Lee, NJ 07024-6627 | 2020-10-22 |
| 1851990220 | Tzvi Friedman | Counselor | 308 South Pkwy, Clifton, NJ 07014-1223 | 2020-10-18 |
| 1285232702 | Guided Growth Therapy, LLC | Counselor | 230 Kings Hwy E Ste 140, Haddonfield, NJ 08033-1907 | 2020-10-16 |
| 1306444518 | Mindful Health Tbi Center Inc | Counselor | 37 Hanover Rd, Marlton, NJ 08053-1905 | 2020-10-12 |
| 1952908261 | Kathryn Vetrano | Counselor | 12 Lakeview St, River Edge, NJ 07661-1720 | 2020-10-08 |
| 1477150324 | Aloha Counseling and Support Services, LLC | Counselor | 5 Madison Ln, Sicklerville, NJ 08081-4410 | 2020-10-05 |
| 1801403175 | Visions and Pathways | Counselor | 49 Brahma Avenue, Bridgewater, NJ 08807 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | NEW PROVIDENCE |
| Zip Code | 07974 |
Please comment or provide details below to improve the information on KWENYAN PROFESSIONAL HEALTH SERVICES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.