NPIMap

Organization Active NPI

Kwenyan Professional Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phillipsburg, NJ
National Provider Identifier
1003392374
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
101950304 Issued in NJ
Legal business name
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
Practice address
291 Pickford Ave
Phillipsburg, NJ 08865-1626
Phone
(908) 777-3744
Fax
(908) 777-3746
NPI assigned
Jul 19, 2018
Organization subpart
Yes
Parent organization
KWENYAN PROFESSIONAL HEALTH SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Dr. Dr. Daniel Estrada Cassell, PH.D., MPH, PH.D., MPH
Title
President/Ceo: Administrator
Phone
(215) 432-3702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 101950304 NJ Primary

Addresses

Primary practice location

291 Pickford Ave
Phillipsburg, NJ 08865-1626

Mailing address

291 Pickford Ave
Phillipsburg, NJ 08865-1626
Phone (908) 777-3744

Other practice location 1

19 Hutton Ave
West Orange, NJ 07052-4803
Phone (973) 672-6900

Other identifiers 1

IdentifierTypeStateIssuer
101950304OtherNJINTENSIVE OUTPATIENT MENTAL HEALTH SERVICES

Other names 1

  • Kwenyan Professional Health Services, LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Kwenyan and Associates6 organizations share this tax ID, including this one
Part of
Kwenyan Professional Health Services LLC

Other organizations with this tax ID 5

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

Locations

291 Pickford Ave
Phillipsburg, NJ 08865
Phone (908) 454-1212

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1003392374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 PICKFORD AVE",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651626",
            "telephone_number": "908-777-3744",
            "fax_number": "908-777-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 PICKFORD AVE",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651626",
            "telephone_number": "908-777-3744",
            "fax_number": "908-777-3746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Hutton Ave",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070524803",
            "country_code": "US",
            "telephone_number": "973-672-6900",
            "fax_number": "866-376-8262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KWENYAN PROFESSIONAL HEALTH SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KWENYAN PROFESSIONAL HEALTH SERVICES, LLC",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "CASSELL, PH.D., MPH",
        "authorized_official_first_name": "DR. DANIEL",
        "authorized_official_middle_name": "ESTRADA",
        "authorized_official_title_or_position": "PRESIDENT/CEO: ADMINISTRATOR",
        "authorized_official_telephone_number": "215-432-3702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., MPH"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "101950304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTENSIVE OUTPATIENT MENTAL HEALTH SERVICES",
            "identifier": "101950304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kwenyan Professional Health Services, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kwenyan Professional Health Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.