St Michael Mental Care Consult LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ST MICHAEL MENTAL CARE CONSULT LLC

Practice address

90 Washington St
East Orange, NJ 07017-1050

Phone

(973) 304-5180

Fax

(973) 399-3786

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Michael EnwereNPI 1417548652

Title

Apn/Owner

Phone

(973) 412-6427

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Practitioners 1

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

• Michael Enwere

  • Psychiatric/Mental Health Nurse Practitioner
  • Summit, NJ
  • NPI 1417548652

  NJ, NY

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1194447144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 GRANT PL",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111441",
            "telephone_number": "973-304-5180",
            "fax_number": "973-399-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WASHINGTON ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171050",
            "telephone_number": "973-304-5180",
            "fax_number": "973-399-3786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 Saint Marks Ave # 1215",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112382268",
            "country_code": "US",
            "telephone_number": "973-304-5180",
            "fax_number": "973-399-3786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST MICHAEL MENTAL CARE CONSULT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "ENWERE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "APN/OWNER",
        "authorized_official_telephone_number": "973-412-6427"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Lee Spitzer, M.D., PH.D.
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• Judy Vanessa Springer, DMD
• Anand Srinivasan, MD
• Mya Nicole St Louis
• Standard Care Medical Transportation LLC
• Shadonae Janelle Stanley
• Richard Craig Stark, M.D.
• Statewide Family Care
• Annemarie Nathalia Staton, NURSE PRACTITIONER

• All providers in East Orange, NJ
• 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 Feb 11, 2026; 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.