Individual provider Active NPI

Alyssa Killion, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Laurel, NJ
National Provider Identifier
1255655874
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00381100 Issued in NJ
Practice address
1200 S Church St Ste 14
Mount Laurel, NJ 08054-2936
Phone
(856) 372-1819
Fax
(856) 872-3643
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00381100 NJ Primary

Addresses

Primary practice location

1200 S Church St Ste 14
Mount Laurel, NJ 08054-2936

Mailing address

1200 S Church St Ste 14
Mount Laurel, NJ 08054-2936
Phone (856) 372-1819

Other practice location 1

102 Browning Lane
Building C Suite 2
Cherry Hill, NJ 08003
Phone (609) 771-3777

Other practice location 2

1014 Whitehead Road Ext
Ewing, NJ 08638-2406
Phone (609) 771-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00381100NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ank Behavioral Health LLC Psychiatric/Mental Health CurrentSince Mar 4, 2021 Accepting new patients
Phoenix Behavioral Health LLC PastSince Jun 23, 2024 Accepting new patients
Phoenix Behavioral Health LLC PastSince Jun 23, 2024 Accepting new patients

Locations

1200 S Church St
Ste 14
Mount Laurel, NJ 08054
Phone (609) 304-4949

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1255655874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 14",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-372-1819",
            "fax_number": "856-872-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 14",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-372-1819",
            "fax_number": "856-872-3643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Browning Lane",
            "address_2": "Building C Suite 2",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "08003",
            "country_code": "US",
            "telephone_number": "609-771-3777",
            "fax_number": "609-436-9699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Whitehead Road Ext",
            "address_purpose": "LOCATION",
            "city": "Ewing",
            "state": "NJ",
            "postal_code": "086382406",
            "country_code": "US",
            "telephone_number": "609-771-3777",
            "fax_number": "609-436-9699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLION",
        "first_name": "ALYSSA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00381100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.