Organization Active NPI

Holistic Urban Guidance Center, Inc

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • West Orange, NJ
National Provider Identifier
1134396161
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
26NR04888600 Issued in NJ
Legal business name
HOLISTIC URBAN GUIDANCE CENTER, INC
Practice address
10 Brook End Dr
West Orange, NJ 07052-1303
Phone
(973) 325-7345
Fax
(973) 325-3715
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Ms. Deanna V Johnson, M.S., APRN, BCNPI 1003820994
Title
Owner
Phone
(973) 325-7345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X 26NR04888600 NJ Primary

Addresses

Primary practice location

10 Brook End Dr
West Orange, NJ 07052-1303

Mailing address

10 Brook End Dr
West Orange, NJ 07052-1303
Phone (973) 325-7345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090422000041 NJ Part B Supplier - Clinic/Group Practice 4789731118 Receives reassigned benefits from 1 practitioner
Practice locations: West Orange, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1134396161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BROOK END DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521303",
            "telephone_number": "973-325-7345",
            "fax_number": "973-325-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BROOK END DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521303",
            "telephone_number": "973-325-7345",
            "fax_number": "973-325-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC URBAN GUIDANCE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-325-7345",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., APRN, BC"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NR04888600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.