Wellness Direct LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00654700 Issued in NJ

Legal business name

WELLNESS DIRECT LLC

Practice address

1425 Pompton Ave
Cedar Grove, NJ 07009-1043

Phone

(973) 464-7139

NPI assigned

Jul 24, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Linda O Winful, PMHNP-BCNPI 1649703299

Title

Apn

Phone

(973) 464-7139

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Linda Winful, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Montclair, NJ
  • NPI 1649703299
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1154844009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CEDAR AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091043",
            "telephone_number": "973-464-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS DIRECT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "WINFUL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "973-464-7139",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00654700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas M Villarosa, DMD
• Matthew Francis Wachtler, DPM
• Michael Wahrsager
• Marc Courtenay Watson, M.D.
• Ronald Wei, MD
• Katherine Whitehouse
• Alexa Maria Wilberton
• Charity Williams, CBD/NCS/BPC
• Annalise Wilner
• Wilson Psychological Associates LLC

• Psychiatric/Mental Health Nurse Practitioner in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.